Paul J. Scheel, MD; Nancy Feeley, CRNP; Stephen M. Sozio, MD, MHS
Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1908.
Reproducible Research Statement:Study protocol: Available from Dr. Scheel (e-mail, PScheel1@jhmi.edu). Statistical code and data set: Not available.
Requests for Single Reprints: Paul J. Scheel Jr., MD, Division of Nephrology, The Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 416, Baltimore, MD 21205; e-mail, PScheel1@jhmi.edu.
Current Author Addresses: Dr. Scheel and Ms. Feeley: Division of Nephrology, The Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 416, Baltimore, MD 21205.
Dr. Sozio: Division of Nephrology, Johns Hopkins Bayview Medical Center, 301 Mason F. Lord Drive, Suite 2515, Baltimore, MD 21224-2780.
Author Contributions: Conception and design: P.J. Scheel.
Analysis and interpretation of the data: P.J. Scheel, S.M. Sozio.
Drafting of the article: P.J. Scheel.
Critical revision of the article for important intellectual content: P.J. Scheel, S.M. Sozio.
Final approval of the article: P.J. Scheel, S.M. Sozio.
Statistical expertise: S.M. Sozio.
Collection and assembly of data: P.J. Scheel, N. Feeley.
Scheel PJ, Feeley N, Sozio SM. Combined Prednisone and Mycophenolate Mofetil Treatment for Retroperitoneal Fibrosis: A Case Series. Ann Intern Med. 2011;154:31-36. doi: 10.7326/0003-4819-154-1-201101040-00005
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Published: Ann Intern Med. 2011;154(1):31-36.
Small case series suggest that a combination of mycophenolate mofetil and prednisone may be an effective treatment for patients with retroperitoneal fibrosis.
To describe the outcomes of adults with retroperitoneal fibrosis who received a combination of prednisone and mycophenolate mofetil.
Prospective case series of patients followed between 1 April 2005 and 1 July 2009.
Single tertiary care facility.
28 patients with retroperitoneal fibrosis.
Prednisone, 40 mg/d, tapered over 6 months, and mycophenolate mofetil, 1000 mg twice daily, for a mean of 24.3 months.
Clinical course, laboratory assessment, and measurement of periaortic mass. Mean follow-up was 1012 days, and no patients were lost to follow-up.
Systemic symptoms resolved in all patients; 89% had a 25% or greater reduction in periaortic mass. Elevated erythrocyte sedimentation rate and serum creatinine level and decreased hemoglobin level normalized in all patients. Disease recurred in 2 of 28 patients.
This was a small case series.
Combined prednisone and mycophenolate mofetil therapy is a potentially effective treatment for retroperitoneal fibrosis that warrants evaluation in randomized trials.
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Nephrology, Urological Disorders, Prevention/Screening.
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