Long-term Outcome Of 52 Patients With Chronic Periaortitis Treated With Steroids, Immunosuppressive Therapy And(or) Tamoxifen

Objective The study aims to assess the therapeutic benefit of medicine treatment in Chronic periaortitis (CP)Method A retrospective study of 52 patients with CP who were treated at Peking Union Medical College Hospital. Summarize the clinical features, the extents of ureteral obstruction, the degrees of renal function, the levels of acute-phase reactants (ESR and C-reactive protein), the sizes of the retroperitoneal fibro-inflammatory tissues with repeated follow-up CT scanning during the period of therapy.Results The most prominent symtom is back or abdominal pain.76.92% of the patients had ureteral obstruction, with 26.92% had a progressive renal insufficiency. After a period of treatment,95.35% of the patients had a significant to complete remission of symptoms. 57.6% was successfully relieved of ureteral obstruction. Creatinine decreased significantly in patients with progressive renal insufficiency(P=0.002). There was also a remarkable decrease in ESR and C-reactive protein a median treatment of 4 weeks. CT scanning showed a 75% mass regression after a median therapy of 6 months, which mainly stabilized in the later period of treatment.Conclusions The clinical manifestations of CP is nonspecific, which often leads to a delayed diagnosis and the late-stage complications. CP could be very effectively treated by a combination of medical managements (corticosteroids and immunosuppressive therapy and(or) tamoxifen) stents/nephrostomies and even surgical approaches if needed, with an excellent long-term outcome and relatively fewer disease relapses.