Combined idiopathic retroperitoneal and mediastinal fibrosis with pericardial involvement

We report the case of a 54-year-old woman with renal failure related to bil ateral hydronephrosis. Clinical and radiologic findings were consistent wit h retroperitoneal fibrosis associated with pleuro-pericardial involvement, These features matched criteria for combined idiopathic retroperitoneal fib rosis and idiopathic mediastinal fibrosis. There are few reported cases of pericardial involvement in this combined disorder. In our observation, nucl ear-magnetic resonance was the radiologic procedure of choice for aortic ex ploration. The responsibility of therapeutic agents (P-adrenoreceptor-block ing drugs and ergotamine) and therapeutic options for the sclerosing diseas e are also discussed. Bilateral ureteral stents and corticosteroids produce d favorable outcome without recurrence one year after treatment was stopped .