Encapsulating peritoneal sclerosis following renal transplantation despite tamoxifen and immunosuppressive therapy
نویسندگان
چکیده
Encapsulating peritoneal sclerosis (EPS) is a rare disease in patients who have undergone peritoneal dialysis (PD). We report a case of EPS following renal transplantation that highlights important clinical issues. Initially, a presumptive diagnosis of EPS was made following surgical and pathological findings at the time of cholecystectomy. CT imaging at this time did not confirm the diagnosis. The patient continued PD and commenced tamoxifen. Prior to and immediately following transplantation, further CT imaging demonstrated no evidence of EPS. Acute bowel obstruction occurred 5 months post-transplantation and a diagnosis of EPS was made both clinically and on CT imaging, despite immunosuppression and tamoxifen. The role of these therapies in managing EPS post-transplant is discussed, in addition to the need for a high index of clinical suspicion to make the diagnosis.
منابع مشابه
Tamoxifen therapy in kidney-transplant patients presenting with severe encapsulating peritoneal sclerosis after treatment for acute humoral rejection.
OBJECTIVES Encapsulating peritoneal sclerosis is a rare but serious complication in patients undergoing peritoneal dialysis. Its mortality rate is approximately 30%, despite treatment with total parenteral nutrition, surgery, tamoxifen, or immunosuppressants. MATERIALS AND METHODS Of 991 kidney transplants performed at our institution over 9 years, 50 patients were treated for chronic periton...
متن کاملSuccessful outcome with early renal transplantation following treatment of encapsulating peritoneal sclerosis
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis (PD) associated with cocooning of the bowel within a sheath of fibrous tissue causing obstruction. Uncertainty remains regarding the aetiology, pathogenesis and optimal treatment. The current management of EPS is largely based on case reports and small series, and there are limited data regarding outcomes of ...
متن کاملTamoxifen as the possible cause of severe thromboembolic complications in a patient with a history of renal transplantation and encapsulating peritoneal sclerosis.
259 In the latest issue of the Polish Archives of Internal Medicine and in the first ever edition of the “Clin‐ ical Image” section of this journal, Jakimowicz et al.1 presented the case of a rare but not unusu‐ al complication of long‐term peritoneal dialysis, namely, encapsulating peritoneal sclerosis (EPS). In the last paragraph, the authors mentioned that tamoxifen, a drug approved for the ...
متن کاملSuccessful treatment of encapsulating peritoneal sclerosis with immunosuppressive therapy.
Encapsulating peritoneal sclerosis is a rare, but potentially lethal, complication of peritoneal dialysis. Treatment of patients with encapsulating peritoneal sclerosis is controversial. Conservative treatment carries a poor outcome, and immunosuppressive drugs are now used frequently. Most commonly, these immunosuppressive regimens include steroids with or without azathioprine or cyclosporine....
متن کاملEncapsulating Peritoneal Sclerosis: Case report and Current Status
Encapsulating peritoneal sclerosis (EPS), is a rare but devastating complication of long-term peritoneal dialysis (PD) with a high mortality rate. The incidence is between 0.5 and 3.3%, decreasing with time. EPS is defi ned as a clinical syndrome with major signs of gastrointestinal obstruction, infl ammatory parameters, radiological and macroscopic changes. Duration of treatment and cessation ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 1 شماره
صفحات -
تاریخ انتشار 2008