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Neue (und alte) Aspekte der retroperitonealen Fibrose

New (and old) aspects of retroperitoneal fibrosis

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Zusammenfassung

Die retroperitoneale Fibrose (RPF) ist eine seltene chronisch entzündlich-fibrosierende Erkrankung des hinteren Bauchraums, deren häufigste Komplikation die uni- oder bilaterale Hydronephrose darstellt. Trotz der Seltenheit der Erkrankung sind in den letzten Jahren eine Vielzahl von Arbeiten zur Ätiologie, Diagnostik, Verlaufskontrolle und Therapie veröffentlicht worden. Die Asbestexposition als Risikofaktor für die Entwicklung einer Fibrose, die Bedeutung der IgG4-assoziierten Fibrose, die Messung der Krankheitsaktivität mittels verschiedener bildgebender und nuklearmedizinischer Verfahren und neue medikamentöse Therapiestrategien sind wichtige Teilaspekte, die untersucht wurden. Als Therapieziele gelten die Sicherung der richtigen Diagnose, die Protektion der Nierenfunktion und die Freiheit von Doppel-J- (DJ-)Schienen, Kortison und Schmerzen. Anhand dieser Therapieziele werden die wichtigsten Erkenntnisse und Entwicklungen der letzten 5 Jahre zu diesem seltenen Krankheitsbild vorgestellt.

Abstract

Retroperitoneal fibrosis (RPF) is an uncommon chronic inflammatory disease of the rear abdomen and it is commonly associated with the complication of uni- or bilateral hydronephrosis. Despite the rarity of this disease, multiple publications concerning etiology, diagnosis, therapy monitoring and both medical and surgical therapy have been published in recent years. Recent research has focused on asbestos exposure as a possible risk factor, the meaning of IgG4-associated RPF, measuring disease activity using different radiological and nuclear medicine procedures, and new approaches to medical therapy. Goals of treatment were characterized as the correct diagnosis, preservation of renal function and freedom from stents, steroids and pain. On the basis of these goals, the most important insights and developments of the last 5 years regarding RPF are presented.

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A.S. Brandt, N.M. Dreger, E. Müller, S. Kukuk und S. Roth geben an, dass kein Interessenkonflikt besteht.

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Brandt, A.S., Dreger, N.M., Müller, E. et al. Neue (und alte) Aspekte der retroperitonealen Fibrose. Urologe 56, 887–894 (2017). https://doi.org/10.1007/s00120-017-0428-y

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