Urology>>>>>Renal Pathophysiology
Question 16#

The following medications are associated with retroperitoneal fibrosis EXCEPT for:

A. Methysergide
B. Hydralazine
C. Alpha-blockers
D. Haloperidol
E. Phenacetin

Correct Answer is C

Comment:

Answer C

Retroperitoneal fibrosis appears as a fibrous, whitish plaque that encases the aorta, inferior vena cava, and their major branches, and also the ureters and other retroperitoneal structures. An underlying malignancy should always be considered as some report to be present in 8%–10%. Other causes include primary (idiopathic), infections such as tuberculosis, drugs including beta blockers, methyldopa, methysergide, hydralazine, haloperidol, phenacetin pergolide, bromocriptine and ergotomines. Previous radiation or surgical treatment to the abdomen and pelvis has also been implicated. MRI allows superior soft tissue discrimination and can more accurately distinguish the plaque from the great vessels than unenhanced CT. If there is evidence of obstructive uropathy at presentation, therapy should be first directed at its correction. Biopsy to exclude malignancy should be performed next. This can be attempted percutaneously with CT, MRI or ultrasound guidance.