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Combined prednisone and mycophenolate mofetil treatment for retroperitoneal fibrosis: a case series

Paul J Scheel1, Nancy Feeley, Stephen M Sozio

  • 1The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA. PScheel1@jhmi.edu

Annals of Internal Medicine
|January 5, 2011
PubMed
Abstract

Insights

This study found that combining prednisone and mycophenolate mofetil effectively treated retroperitoneal fibrosis. Most patients experienced symptom resolution and reduced mass size, with low recurrence rates.

Area of Science:

  • Nephrology
  • Immunology
  • Rheumatology

Background:

  • Retroperitoneal fibrosis (RPF) treatment options are limited.
  • Small studies suggest mycophenolate mofetil and prednisone may be effective.

Purpose of the Study:

  • To evaluate the outcomes of RPF patients treated with prednisone and mycophenolate mofetil.

Main Methods:

  • Prospective case series of 28 RPF patients.
  • Treatment: Prednisone (40 mg/d tapered over 6 months) and mycophenolate mofetil (2000 mg/d).
  • Mean follow-up of 1012 days.

Main Results:

  • Complete resolution of systemic symptoms in all patients.
  • 89% showed ≥25% reduction in periaortic mass.
  • Normalization of inflammatory markers and creatinine; low recurrence (2/28 patients).

Conclusions:

  • Combined prednisone and mycophenolate mofetil therapy is a potentially effective treatment for RPF.
  • Further evaluation in randomized trials is warranted.

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