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Kharagjitsing H, van Eekeren R, van Puijenbroek EP, van Gelder T, van Bommel EFH. Retroperitoneal fibrosis and β-blocking agents: Is there an association? Br J Clin Pharmacol 2021; 87:2891-2901. [PMID: 33326117 DOI: 10.1111/bcp.14702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/31/2020] [Accepted: 12/06/2020] [Indexed: 11/29/2022] Open
Abstract
AIMS Retroperitoneal fibrosis (RPF) is a rare chronic fibro-inflammatory disorder that may be secondary to certain drugs, including β-blocking agents (BBAs). However, their causative role is unclear. We aimed to investigate this association. METHODS Disproportionality analysis was carried out on cases from 1985 to 4 October 2020 in VigiBase, the World Health Organization pharmacovigilance database. The Bayesian-based IC025 metric and reporting odds ratio were used in order to assess the adverse event signal. We also analysed all published case reports from the literature regarding BBA-associated RPF to assess the value of suggested supportive clinical evidence. RESULTS In total, 1599 individual case safety reports of RPF were reported to VigiBase, of which 132 (32%) concerned 16 different single BBA. For 12 of these agents (75%), reporting of RPF was disproportionate, indicating a potential safety signal. Line listing analysis of individual case safety reports showed no consistent time interval from start of BBA to RPF diagnosis (range 0.7-264 mo). Dechallenge was negative or unknown in the majority of cases (74%). In 18 published cases from the literature, time from start of BBA to RPF diagnosis varied widely (range 3-156 mo). BBA were discontinued 6 months before (n = 1) or at the time of RPF diagnosis (n = 17). Most patients (84%) also received RPF specific treatment. Follow-up duration was short (median 5 mo [range 1-24 mo]) and in most cases (83%) relevant follow-up data were lacking. CONCLUSION Although disproportionality analysis indicated a potential safety signal for RPF associated with BBAs, clinical evidence did not support a cause-and-effect relationship.
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Affiliation(s)
- Hardjit Kharagjitsing
- Department of Internal medicine, Dutch national center of expertise for retroperitoneal fibrosis, Albert Schweitzer hospital, Dordrecht, The Netherlands.,Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Rike van Eekeren
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.,Department of Pharmacotherapy, epidemiology and economics, Groningen Research Institute of Pharmacy, University of Groningen, The Netherlands
| | - Eugène P van Puijenbroek
- Netherlands Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.,Department of Pharmacotherapy, epidemiology and economics, Groningen Research Institute of Pharmacy, University of Groningen, The Netherlands
| | - Teun van Gelder
- Department of Clinical Pharmacy & Toxicology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eric F H van Bommel
- Department of Internal medicine, Dutch national center of expertise for retroperitoneal fibrosis, Albert Schweitzer hospital, Dordrecht, The Netherlands
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Brasselet D, Chouchana L, Vial T, Damin-Pernik M, Lebrun-Vignes B. Drug-induced retroperitoneal fibrosis: a case/non-case study in the French PharmacoVigilance Database. Expert Opin Drug Saf 2020; 19:903-914. [DOI: 10.1080/14740338.2020.1766022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Diana Brasselet
- University Hospital Pitié Salpêtrière, Regional Pharmacovigilance Center, Paris, France
| | - Laurent Chouchana
- AP-HP, Cochin Hospital, Regional Pharmacovigilance Center, Paris, France
| | - Thierry Vial
- Hospices Civils de Lyon, Centre Régional de Pharmacovigilance, Lyon, France
| | - Marlène Damin-Pernik
- Centre Hospitalier Universitaire de Saint-Etienne, Regional Pharmacovigilance Center Saint-Etienne, Rhône-Alpes, France
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Urban ML, Palmisano A, Nicastro M, Corradi D, Buzio C, Vaglio A. Idiopathic and secondary forms of retroperitoneal fibrosis: a diagnostic approach. Rev Med Interne 2014; 36:15-21. [PMID: 25455951 DOI: 10.1016/j.revmed.2014.10.008] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 10/13/2014] [Indexed: 10/24/2022]
Abstract
Retroperitoneal fibrosis (RPF) is an uncommon disease characterized by a fibrous reaction that takes place in the peri-aortic retroperitoneum and often entraps the ureters causing obstructive uropathy. RPF is idiopathic in the majority of cases, but can also be secondary to malignancies, infections, drugs, radiotherapy, and rare histiocytic disorders such as Erdheim-Chester disease. Idiopathic RPF is an immune-mediated disease, which can either be isolated, associated with other autoimmune diseases, or arise in the context of a multifocal fibro-inflammatory disorder recently renamed as IgG4-related disease. The differential diagnosis between idiopathic, IgG4-related and secondary RPF is crucial, essentially because the therapeutic approaches - especially of idiopathic vs. secondary RPF - can be dramatically different. This review focuses on the clinical, laboratory and imaging features of the different RPF forms, and also provides an overview of the available treatment options.
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Affiliation(s)
- M L Urban
- Unit of nephrology, university hospital, Parma, Italy
| | - A Palmisano
- Unit of nephrology, university hospital, Parma, Italy
| | - M Nicastro
- Unit of nephrology, university hospital, Parma, Italy
| | - D Corradi
- Section of pathology and laboratory medicine, department of biomedical, biotechnological and translational sciences, university hospital, Parma, Italy
| | - C Buzio
- Unit of nephrology, university hospital, Parma, Italy
| | - A Vaglio
- Unit of nephrology, university hospital, Parma, Italy.
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Abstract
Retroperitoneal fibrosis (RPF) is a condition characterized by the presence of inflammation and fibrosis in the retroperitoneal space, for which no standard diagnostic criteria exist. Historically, treatment has focused on relieving the obstruction with percutaneous or cystoscopic assisted placement of ureteral stents followed by more definitive resolution of ureteric obstruction with open or laparoscopic ureterolysis. However, over the past several years management has shifted from primarily a surgical approach to an immunosuppressive-based therapy aimed at modulation of the immune system. This review focuses on the recent advances in the classification, epidemiology, pathophysiology, pathology, imaging, and treatment of RPF.
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Affiliation(s)
- Paul J Scheel
- Division of Nephrology, The Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 416, Baltimore, MD 21205, USA.
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Lemy AA, del Marmol V, Kolivras A, High WA, Matos C, Laporte M, Nortier JL. Revisiting nephrogenic systemic fibrosis in 6 kidney transplant recipients: A single-center experience. J Am Acad Dermatol 2010; 63:389-99. [DOI: 10.1016/j.jaad.2009.10.038] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2009] [Revised: 10/20/2009] [Accepted: 10/24/2009] [Indexed: 10/19/2022]
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Scheel PJ, Feeley N. Retroperitoneal fibrosis: the clinical, laboratory, and radiographic presentation. Medicine (Baltimore) 2009; 88:202-207. [PMID: 19593224 DOI: 10.1097/md.0b013e3181afc439] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Retroperitoneal fibrosis (RPF) is an inflammatory disorder that affects the infrarenal great vessels and surrounding structures. Although first described in 1948 by Ormond, much of the information currently available on this disease is conflicting and results from multiple definitions used by different investigators. We conducted the current study to describe the clinical, laboratory, and radiographic presentation of RPF from a single center using data collected in a prospective fashion.Data on all patients who were referred to our RPF clinic were prospectively collected. We obtained information on presenting signs and symptoms, and on the presence or absence of "traditional risk factors," comorbidities, and family histories. All patients underwent the same battery of laboratory testing, including complete blood count, renal function profile, erythrocyte sedimentation rate (ESR), thyroid-stimulating hormone, and antinuclear antibodies (ANA). All patients had contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen and pelvis. The extent of disease was classified based on the anatomic location of the soft-tissue density.Forty-eight patients (26 male and 22 female) met the criteria for RPF and were included in the study. The mean age was 54.25 years. Few patients had traditional risk factors for RPF. Pain and weight loss were the most common presenting symptoms. The mean hemoglobin was 11.6 g/dL. The mean ESR was 40.5 mm/h. Nine patients had positive ANA, all with negative antibodies to dsDNA. CT or MRI revealed the presence of a periaortic soft-tissue density in all (100%) patients; 69% had pericaval involvement, 62% had obstruction of 1 or both ureters, and 35% of patients had involvement of the renal artery or renal vein.In the current report we present the demographics and laboratory and radiographic presentation of a homogenous group of patients with RPF. We attempt to solidify a proper scheme of classification for the disease, and suggest an anatomic classification system that may be used for future studies.
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Affiliation(s)
- Paul J Scheel
- From the Division of Nephrology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Ross JJ, Rahman I, Walters RF. Peyronie's disease following long-term use of topical timolol. Eye (Lond) 2005; 20:974-6. [PMID: 16151480 DOI: 10.1038/sj.eye.6702088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lascarides CE, Bini EJ, Newman E, Gordon RB, Sidhu GS, Cohen J. Intrinsic common bile duct stricture: an unusual presentation of retroperitoneal fibrosis. Gastrointest Endosc 1999; 50:102-5. [PMID: 10385734 DOI: 10.1016/s0016-5107(99)70356-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- C E Lascarides
- Department of Medicine, Division of Gastroenterology, New York VA Medical Center, New York, NY 10010, USA
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D'Amico A, Ficarra V, Porcaro A, Puce R, Cicuto S, Malossini G, Tallarigo C. L'eziopatogenesi della fibrosi retroperitoneale: Etiopathogenesis of retroperitoneal fibrosis. Urologia 1998. [DOI: 10.1177/039156039806500213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The etiopathogenesis of retroperitoneal fibrosis is still obscure and probably multifactorial. Among the secondary forms due to demonstrable causes, the one caused by aorto-iliac atherosclerosis has recently been recognised. Its pathogenesis is linked to the low density oxidised lipoproteins of the atheromatous plaque, which are responsible for a local immunologic reaction. The most common form is still idiopathic or primitive, hypothetically related to genetic, environmental, vascular and/or immunologic factors. Idiopathic retroperitoneal fibrosis is sometimes associated with other sclerosing syndromes and/or systemic diseases. In such cases a common pathogenesis, probably immunologic may be postulated. After having illustrated the different categories of retroperitoneal fibrosis, the authors report their experience with 25 patients of whom 14 had idiopathic fibrosis and 11 secondary fibrosis. In the former group 11 patients (78.5%) smoked more than 10 cigarettes a day, while there was a history of prolonged professional exposure to asbestos in one case. The following associated pathologies were observed: hypertension in 7 cases (50%), ischemic cardiopathy in 2 (14.3%), diabetes mellitus in 2 (14.3%), multiple myeloma in 1 (7.1%) and juvenile rheumatoid arthritis in 1 (7.1%). The disease was also associated with other sclerosing pathologies in 3 cases: sclerosing cholangitis in 2 and Dupuytren's contracture in 1. The location of the fibrosis was typically periaortic in 13 cases (92.8%), as shown by CT. Lastly, 10 patients underwent immunosuppressive therapy with a favourable response, suggesting the probable immunologic pathogenesis of the disease.
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Affiliation(s)
- A. D'Amico
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
- Divisione Clinicizzata di Urologia, Ospedale Policlinico - Via delle Menegone - 37134 Verona - Italy
| | - V. Ficarra
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - A. Porcaro
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - R. Puce
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - S. Cicuto
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - G. Malossini
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
| | - C. Tallarigo
- Cattedra e Divisione Clinicizzata di Urologia - Università degli Studi - Verona
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