A case of a dialysis patient with sclerosing peritonitis successfully treated with corticosteroid therapy alone

Mori, Yoshiko; Matsuo, Seiichi; Sutoh, Hidemasa; Toriyama, Takanobu; Kawahara, Hirohisa; Hotta, Nigishi

doi:10.1016/s0272-6386(97)90064-0

Cited by 81 publications

(61 citation statements)

References 18 publications

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“…In Japan, enterolysis (surgical division of adhesions) is recommended but there are few European reports on EPS surgery (11)(12)(13)(14)(15). Case series have assessed total parenteral nutrition, immunosuppression and tamoxifen, and some have shown encouraging results (3,7,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26). There are no reliable biochemical or radiologic screening tests to identify patients at risk or in the early stages of EPS (27,28).…”

mentioning

confidence: 99%

Encapsulating Peritoneal Sclerosis in the New Millennium

Brown

Simpson

Kerssens

et al. 2009

Clinical Journal of the American Society of Nephrology

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confidence: 99%

Encapsulating Peritoneal Sclerosis in the New Millennium

Brown

Simpson

Kerssens

et al. 2009

Clinical Journal of the American Society of Nephrology

182

205

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“…Many reports in literature describe the beneficial effects of immunosuppressive agents on the progression of SEP [12][13][14]. Patients with SEP have been successfully treated with corticosteroids alone or in combination with azathioprine [11,14,15].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with SEP have been successfully treated with corticosteroids alone or in combination with azathioprine [11,14,15]. Examples of other immunosuppressants like colchicine, tamoxifen, renin-angiotensin inhibitors, phosphatidylcholine and antifibrotic agents have also been trialed in management of mild disease and outcomes were inconclusive [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…It was proposed that immunosuppressive therapy could slow the progression of SEP by reducing the production of inflammatory mediators, which promote fibrinogenesis; hence, formation of fibrous capsule [12]. Due to the sporadic nature and low incidence of the disease, there is a lack of literature to conclude on the significance of long-term immunosuppressive therapy and treatment durations have varied between 3-4 months to life-long treatment [11,14,15]. This patient's symptoms at initial presentation were non-specific.…”

Section: Khoo Et Al 214mentioning

confidence: 99%

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An unusual presentation of encapsulating sclerosing peritonitis

Khoo¹,

Palamuthusingam²,

Mutatiri³

2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations.IJCRI publishes Review Articles, Case Series, Case Reports, Case in Images, Clinical Images and Letters to Editor. Website: www.ijcasereportsandimages.comAn unusual presentation of encapsulating sclerosing peritonitis Emmi Khoo, Dharmenaan Palamuthusingam, Clyson Mutatiri ABSTRACT Introduction: Sclerosing encapsulating peritonitis (SEP) is a rare condition. Underlying cause of SEP is believed to be multifactorial. It can occur secondary to several conditions like prior episodes of severe peritonitis, use of beta-blockers, history of peritoneal dialysis, autoimmune disease, intra-abdominal malignancies, exposure to chemicals such as silicosis or asbestosis, endometriotic cyst, uterine leiomyomas, ovarian tumors, sarcoidosis, or tuberculosis. Case Report: We report an unusual case of a 74-year-old male patient of Dutch descent presented with intermittent watery diarrhea, recurrent ascites and bilateral lower limb lymphedema. Conclusion: Symptoms of the patient at initial presentation were non-specific. Bilateral lower limb lymphedema has not been previously identified in literature as a presenting symptom of this disease. Clinicians need to have a higher index of suspicion for the diagnosis of SEP in those that present with bilateral lower limb lymphedema and non-specific abdominal symptoms. The etiology of SEP in this patient remains unclear, which is consistent with most of the cases reported in literature to date.

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“…Some reports have suggested that corticosteroid therapy was effective for patients with EPS due to the prevention of fibroneogenesis (3,6). Peritoneal lavage therapy has also been reported to be useful for EPS (8-10).…”

Section: Discussionmentioning

confidence: 99%

Prognosis of Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) for Over 10 Years

et al. 2011

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Background Patients who have been on continuous ambulatory peritoneal dialysis (CAPD) for over 10 years are known to have a risk of developing encapsulating peritoneal sclerosis (EPS). However, the prognosis of patients on CAPD for over 10 years remains unclear. Methods To better understand the efficacy of a variety of treatments for EPS, we retrospectively reviewed 25 patients who started CAPD at Toranomon Hospital from 1981 to 1997 and continued it for longer than 10 years. Results The CAPD catheter was removed without peritoneal lavage in the initial 3 patients and they developed massive ascites. They all died of infection without resolution of the ascites. Accordingly, in the remaining 13 patients who did not undergo kidney transplantation, peritoneal lavage therapy was performed for 12 months before removing the CAPD catheter. As a result, 4 patients did not develop EPS. However, 9 patients had EPS with ascites, among whom 4 died of EPS-related diseases and 5 are alive. Five patients underwent cadaveric donor kidney transplantation. At the time of surgery, the CAPD catheter was removed without peritoneal lavage; 1 patient suffered from massive ascites immediately, although this subsided within 3 months after kidney transplantation, and 4 patients remain free from EPS-related symptoms and are doing well. Conclusion Kidney transplantation may be an option for preventing EPS. This study showed that improvement of the uremic state as well as treatment with immunosuppressants including corticosteroids may contribute to preventing EPS.

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A case of a dialysis patient with sclerosing peritonitis successfully treated with corticosteroid therapy alone

Cited by 81 publications

References 18 publications

Encapsulating Peritoneal Sclerosis in the New Millennium

Encapsulating Peritoneal Sclerosis in the New Millennium

An unusual presentation of encapsulating sclerosing peritonitis

Prognosis of Patients on Continuous Ambulatory Peritoneal Dialysis (CAPD) for Over 10 Years

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