title: Discovering implicit associations in a case of encapsulating peritoneal sclerosis complicated by severe mineral imbalance.
abstract: We describe the case of a 42-year-old woman who developed encapsulating peritoneal sclerosis (EPS) after 7 years on peritoneal dialysis, with clinical relief by enterolysis associated to treatment with tamoxifen, corticosteroids and parenteral nutrition in haemodialysis. During the next 7 months, she was also conservatively stabilised for mild hyperparathyroidism until she was admitted with calciphylaxis, associated with massive extraosseous calcification. Despite parathyroidectomy and sodium thiosulfate treatment, which resulted in a successful resolution of calciphylaxis, she died 1 year later due to a gross calcified peritoneum. In view of controlled hyperparathyroidism, the massive extraosseous calcification beginning after EPS diagnosis furthermore corroborates a recently suggested role for calcium-regulatory factors associated with poor outcome in EPS.
authors.affiliation: Hospital Faro, Faro, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Pinho
authors.affiliation: Hospital Faro, Faro, Portugal.
authors.forename: Isabel
authors.initials: I
authors.lastname: Pinto
authors.affiliation: Hospital Faro, Faro, Portugal.
authors.forename: Sandra
authors.initials: S
authors.lastname: Sampaio
authors.affiliation: Hospital Faro, Faro, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: Neves
mesh_terms: D000328:Adult; D002115:Calciphylaxis / Q000150:complications* / Q000188:drug therapy; D017809:Fatal Outcome; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006961:Hyperparathyroidism / Q000150:complications / Q000188:drug therapy; D016105:Parathyroidectomy / Q000379:methods; D010289:Parenteral Nutrition, Total / Q000379:methods; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects*; D056627:Peritoneal Fibrosis / Q000150:complications* / Q000188:drug therapy; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000473:pathology; D013629:Tamoxifen / Q000627:therapeutic use; D013885:Thiosulfates / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D005938:Glucocorticoids; D013885:Thiosulfates; D013629:Tamoxifen; C017717:sodium thiosulfate