Chronic Periaortitis Research Articles

Retroperitoneal Fibrosis Revisited

Available histopathologic evidence suggests that most cases of the disease called idiopathic retroperitoneal fibrosis are essentially identical to those referred to as idiopathic mediastinal fibrosis, perianeurysmal retroperitoneal fibrosis, and inflammatory aneurysm of the aorta. The name chronic periaortitis includes all of these variants and chronic periarteritis refers to the uncommon associated involvement of coronary arteries. It has been proposed that the cause of the disease is a local autoallergic reaction to components of atherosclerotic plaques. Some recent evidence supports that view, but as yet there is no definite proof. Surgical ureterolysis is the treatment of choice in typical uncomplicated cases, but an important characteristic of the disease is its sensitivity to corticosteroids.

The localisation of immunoglobulin in chronic periaortitis

An immunohistochemical study was undertaken in an attempt to localise immunoglobulin in sections of human advanced atherosclerosis with thinning of the media (sub-clinical periaortitis) and without thinning of the media as well as sections of artery from patients with clinical periaortitis. The findings were that in routinely processed sections of advanced atherosclerosis showing medial attenuation and in sections from cases of clinical periaortitis IgG, and to a lesser extent IgM, was localised to insoluble lipid, ceroid, within the atheroma itself. It is suggested that these observations support the hypothesis that chronic periaortitis has an auto-allergic cause and that the allergen may be a component of ceroid, which is elaborated within the atheroma.