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Volume 32, Issue 2, June 2021




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Mediterr J Rheumatol 2021;32(2):168-73
Ergotamine Induced Retroperitoneal Fibrosis
Authors Information

1. Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
2. Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneshwar, Odisha, India
3. Department of Surgical Oncology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
4. Department of Urology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
5. Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India

Padhan P, Kar M, Nayak P 

Abstract

Retroperitoneal fibrosis (RPF) is an uncommon disease characterised by the presence of fibroinflammatory reaction which starts around the infrarenal portion of the abdominal aorta in the retroperitoneum and frequently entrap the ureter causing obstructive uropathy. Approximately, two thirds of the cases are idiopathic, where aetiopathogenesis is not known. Ergotamine-induced RPF, although rare, is considered under secondary group. The fibrogenic process here is thought to be due to serotonergic activity. We report a case of RPF in a young female with obstructive uropathy who had history of long-term ergotamine intake for migraine. Histopathological evaluation revealed different evolving stages of necrotising vasculitis. In addition, the patient has responded to withdrawal of offending drug along with immunosuppressive therapy. We believe, apart from serotonergic activity, ergotamine can lead to RPF through a vasculitic process which has not been reported earlier.



Article Submitted: 6 Aug 2020; Revised Form: 13 Sep 2020; Article Accepted: 30 Sep 2020; Available Online: 30 Jun 2021

https://doi.org/10.31138/mjr.32.2.168

This work is licensed under a Creative Commons Attribution 4.0 International License (CC-BY). 

©Patra S, Padhi S, Padhan P, Kar M, Nayak P, Samal SC.