Hydronephrosis associated with retroperitoneal fibrosis and sclerosing pancreatitis

Lancet. 2002 Apr 20;359(9315):1403-4. doi: 10.1016/s0140-6736(02)08359-9.


Sclerosing pancreatitis is associated with raised concentrations of IgG4. We treated 22 patients with sclerosing pancreatitis, and identified and followed-up three with concomitant hydronephrosis caused by ureteral mass, later diagnosed as retroperitoneal fibrosis. We histologically examined the ureteral and pancreatic lesions of these patients and noted abundant infiltration of IgG4-bearing plasma cells in both tissues. Treatment with corticosteroids lowered serum concentrations of IgG4. IgG4 might also have a pathological role in a systemic fibrosing process that includes pancreatic and retroperitoneal lesions.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease
  • Humans
  • Hydronephrosis / etiology*
  • Immunoglobulin G / isolation & purification
  • Male
  • Middle Aged
  • Pancreas / pathology*
  • Pancreatitis / complications*
  • Pancreatitis / pathology
  • Plasma Cells / immunology
  • Retroperitoneal Fibrosis / complications*
  • Retroperitoneal Fibrosis / diagnosis*
  • Sclerosis / complications
  • Ureter / pathology*


  • Immunoglobulin G