Biomedical subjects
Publications and source records attributed to V Estrade.
The rare occurrence of retroperitoneal fibrosis contrasts with the multitude of publications. Its clinical expression also contrasts with the severity of its repercussion on renal function. Now, diagnostic and therapeutic are more standardized to improve chances of preserving renal function. However, no surgical or medical therapy has been tested in a randomized, controlled trial. This article proposes an update of knowledge on this subject.
BACKGROUND: Hemorrhagic cystitis (HC) is a common complication following allogeneic stem cell transplantation (SCT). In rare cases, it can be severe, inducing kidney failure and sepsis, and become life-threatening. METHODS: We report three cases of severe HC in stem cell transplant recipients. Risk factors and the management of these patients were studied, as well as severe HC cases reported in the literature. RESULTS: All three patients received high-dose cyclophosphamide in addition to total body irradiation or busulfan in their preparative regimen. They underwent allogeneic SCT, one of them from unrelated cord blood. BK viruria was detected in two cases at the onset of hematuria. HC lasted for more than 3 months, resulting in urinary tract obstruction and sepsis. Ultimately, cystectomy was the last therapeutic procedure available to treat this life-threatening complication. CONCLUSION: We describe three patients, among a total of more than 1300 patients treated in our unit by allogeneic bone marrow transplantation, in whom HC was severe and long lasting enough to require cystectomy as a life-saving procedure.