Idiopathic retroperitoneal fibrosis presenting with recurrent bilateral uveitis

Summary

Patients with recurrent uveitis are often evaluated for the presence of underlying systemic disease. The authors describe a 55-year-old black female who presented with isolated recurrent anterior uveitis. Laboratory evaluations were notable for elevated inflammatory markers. She subsequently developed left lower extremity painless swelling; ultrasound evaluation was negative for deep venous thrombosis. CT scan of her abdomen and pelvis demonstrated multiple amorphous soft tissue densities throughout the small bowel mesentery and retroperitoneum, associated with left-sided hydronephrosis. Histopathology of a retroperitoneal mass demonstrated retroperitoneal fibrosis (RPF). Treatment with systemic corticosteroids led to shrinkage of her mesenteric and retroperitoneal masses, resolution of uveitis and normalisation of inflammatory markers. Albeit rare, RPF should be considered in the diagnostic investigation of patients with recurrent uveitis, especially those with abdominopelvic or lower extremity complaints.