Successful 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. 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.
Lafrance
Jean-Philippe
JP
Nephrology Division, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, Quebec, Canada. jean-philippe.lafrance@umontreal.ca
Létourneau
Isabelle
I
Ouimet
Denis
D
Bonnardeaux
Alain
A
Leblanc
Martine
M
Mathieu
Nicole
N
Pichette
Vincent
V
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001201:Ascites / Q000209:etiology; D001202:Ascitic Fluid / Q000382:microbiology; D041221:Candida glabrata / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy / Q000209:etiology; D005260:Female; D005355:Fibrosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D007415:Intestinal Obstruction / Q000209:etiology; D007421:Intestine, Small / Q000473:pathology*; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D010532:Peritoneal Diseases / Q000188:drug therapy* / Q000209:etiology* / Q000401:mortality / Q000473:pathology; D010537:Peritoneum / Q000473:pathology*; D010538:Peritonitis / Q000188:drug therapy / Q000209:etiology; D011241:Prednisone / Q000627:therapeutic use; D012598:Sclerosis / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D013212:Staphylococcus epidermidis / Q000302:isolation & purification
D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid; D011241:Prednisone