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Posttransplant encapsulating peritoneal sclerosis, long-term success with everolimus and low-dose CNI: a case report.

Abstract
Encapsulating peritoneal sclerosis is a serious complication of peritoneal dialysis and can occur even after transplant. The gut is partially or totally enveloped by a thick fibrous membrane that leads to the formation of multiple sections containing intestinal loops contracted and reduced in volume. Exacerbation after renal transplantation is a very rare but sometimes dramatic condition. We report a patient who developed intestinal obstruction due to encapsulating peritoneal sclerosis 1 year after a deceased-donor kidney transplant. Treatment included laparotomy, small-bowel lengthening by release of adhesions, and high doses of corticosteroids. The patient received immunosuppressive therapy with a combination of low-dose cyclosporine, everolimus, and prednisone, unchanged except for a temporary steroid increase in the postoperative period. We report success with this combined surgical plus medical therapy, with no recurrence after 81 months of follow-up.
AuthorsJ Romagnoli, J A Pedroso, M Paola Salerno, E Favi, G Spagnoletti, F Citterio
JournalTransplantation proceedings (Transplant Proc) Vol. 46 Issue 7 Pg. 2368-70 (Sep 2014) ISSN: 1873-2623 [Electronic] United States
PMID25242790 (Publication Type: Case Reports, Journal Article)
CopyrightCopyright © 2014 Elsevier Inc. All rights reserved.
Chemical References
  • Calcineurin Inhibitors
  • Glucocorticoids
  • Immunosuppressive Agents
  • Cyclosporine
  • Everolimus
  • Prednisone
  • Sirolimus
Topics
  • Adult
  • Calcineurin Inhibitors (administration & dosage)
  • Cyclosporine (administration & dosage)
  • Drug Therapy, Combination
  • Everolimus
  • Female
  • Glucocorticoids (administration & dosage)
  • Humans
  • Immunosuppressive Agents (therapeutic use)
  • Intestinal Obstruction (etiology)
  • Kidney Transplantation
  • Peritoneal Dialysis
  • Peritoneal Fibrosis (complications, drug therapy)
  • Prednisone (administration & dosage)
  • Sirolimus (analogs & derivatives, therapeutic use)

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