[A case of multifocal fibrosis]

Area of Science:

• Nephrology
• Cardiology
• Pathology

Background:

• Multifocal fibrosis, including retroperitoneal Ormond's syndrome, can lead to severe systemic complications.
• Fibrotic processes can extend to mediastinal, pericardial, and cardiac structures, impacting cardiac function.
• Ureteral obstruction and subsequent hydronephrosis are known complications of retroperitoneal fibrosis.

Observation:

• A 20-year history of multifocal fibrosis was observed, presenting with urinary tract obstruction and bilateral ureterohydronephrosis.
• Mediastinal and pericardial fibrosis manifested as exudative and constrictive pericarditis.
• Cardiac involvement included sinus node dysfunction and intraventricular block due to fibrosis of the conducting system.

Findings:

• The patient developed chronic renal insufficiency secondary to ureterohydronephrosis.
• Extensive fibrosis was documented retroperitoneally, paraaortically, paraorbitally, and periportally.
• Diagnosis was confirmed via clinical presentation and multi-slice computed tomography (MSCT).

Implications:

• This case highlights the extensive organ damage possible from multifocal fibrosis, leading to chronic renal insufficiency and cardiac conduction abnormalities.
• The limited efficacy of immunosuppressive therapy underscores the importance of early diagnosis and intervention for fibrotic diseases.
• Irreversible structural and functional organ changes limit treatment options, emphasizing the progressive nature of the condition.