Successful treatment of encapsulating peritoneal sclerosis with immunosuppressive therapy.

Abstract

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. Mycophenolate mofetil is a reversible DNA synthesis inhibitor that frequently replaces azathioprine in renal transplantation because of its improved immunosuppressive potency and better side-effect profile. We report 3 cases of encapsulating peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients for which an association of prednisone and mycophenolate mofetil significantly modified the evolution of the disease. All 3 patients showed significant improvement within a month and are still alive more than 2 years after the diagnosis of encapsulating peritoneal sclerosis. None experienced a relapse or abdominal symptoms, and body weights are stable. This is the first report of 3 cases of successful treatment of patients with encapsulating peritoneal sclerosis with prednisone and mycophenolate mofetil.

• Authors: Jean-Philippe Lafrance, Isabelle Létourneau, Denis Ouimet, Alain Bonnardeaux, Martine Leblanc, Nicole Mathieu, Vincent Pichette
• Journal: American journal of kidney diseases : the official journal of the National Kidney Foundation (Am J Kidney Dis) Vol. 51 Issue 2 Pg. e7-10 (Feb 2008) ISSN: 1523-6838 [Electronic] United States
• PMID: 18215692 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Immunosuppressive Agents
• Mycophenolic Acid
• Prednisone

Topics

• Adult
• Anti-Inflammatory Agents (therapeutic use)
• Ascites (etiology)
• Ascitic Fluid (microbiology)
• Candida glabrata (isolation & purification)
• Candidiasis (drug therapy, etiology)
• Female
• Fibrosis (complications, drug therapy, etiology)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Intestinal Obstruction (etiology)
• Intestine, Small (pathology)
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Peritoneal Dialysis, Continuous Ambulatory (adverse effects)
• Peritoneal Diseases (drug therapy, etiology, mortality, pathology)
• Peritoneum (pathology)
• Peritonitis (drug therapy, etiology)
• Prednisone (therapeutic use)
• Sclerosis (complications, drug therapy, etiology)
• Staphylococcus epidermidis (isolation & purification)