title: Encapsulating peritoneal sclerosis: surgery, sustained drug therapy and treatment of recurrence at 1 year.
abstract: A 74-year-old woman with end-stage renal disease presented with clinical symptoms of encapsulating peritoneal sclerosis 2 years after switching from peritoneal dialysis to haemodialysis. Imaging revealed a large cystic structure in her abdomen and her final diagnosis was made by exploratory laparotomy. A 10 cm×15 cm fibrous rind was excised from the peritoneum and the patient was subsequently started on tamoxifen 20 mg daily and prednisone 20 mg daily. Given her reduction in clinical symptoms and concerns about the long-term effects of corticosteroids, prednisone was tapered and she remained on tamoxifen monotherapy. 1 year postsurgery, she presented with symptoms of nausea, vomiting and anorexia. A repeat CT of the abdomen confirmed a recurrence of encapsulating peritoneal sclerosis. Prednisone and tamoxifen were restarted at increased dosages of 25 and 40 mg daily, respectively. The patient's symptoms were ameliorated within 2 weeks of drug therapy modification.
authors.affiliation: Renal Program, Fraser Health Authority, Surrey, British Columbia, Canada Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Robin
authors.initials: R
authors.lastname: Cho
authors.affiliation: Lower Mainland Pharmacy Services, Surrey, British Columbia, Canada.
authors.forename: Danielle
authors.initials: D
authors.lastname: Ghag
authors.affiliation: Division of Nephrology, Fraser Health Authority, Surrey, British Columbia, Canada Division of Nephrology, Faculty of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Mohamud Amirali
authors.initials: MA
authors.lastname: Karim
authors.affiliation: Renal Program, Fraser Health Authority, Surrey, British Columbia, Canada Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Clifford
authors.initials: C
authors.lastname: Lo
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000628:therapy*; D009325:Nausea / Q000209:etiology; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000379:methods*; D056627:Peritoneal Fibrosis / Q000175:diagnosis* / Q000188:drug therapy; D011241:Prednisone / Q000627:therapeutic use; D013629:Tamoxifen / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology
chemical_list: D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents; D013629:Tamoxifen; D011241:Prednisone