title: Encapsulating peritoneal sclerosis following renal transplantation despite tamoxifen and immunosuppressive therapy.
abstract: 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.
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Declan
authors.initials: D
authors.lastname: de Freitas
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Titus
authors.initials: T
authors.lastname: Augustine
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Hurst
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Taylor
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Rosalind
authors.initials: R
authors.lastname: Williams
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Alastair
authors.initials: A
authors.lastname: Hutchison
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Paul E C
authors.initials: PE
authors.lastname: Brenchley
authors.affiliation: Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester , UK.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Summers
keywords: EPS; immunosuppression; tamoxifen; transplantation