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NDT Plus Advance Access originally published online on August 8, 2008
NDT Plus 2008 1(5):333-335; doi:10.1093/ndtplus/sfn109
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Encapsulating peritoneal sclerosis following renal transplantation despite tamoxifen and immunosuppressive therapy

Declan de Freitas, Titus Augustine, Helen Hurst, Paul Taylor, Rosalind Williams, Alastair Hutchison, Paul E. C. Brenchley and Angela M. Summers

Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Manchester, UK

Correspondence: Correspondence and offprint requests to: Angela M. Summers, Manchester Institute of Nephrology and Transplantation, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK. Tel: +44-161-276-3393; Fax: +0161 276 6908; E-mail: angela.summers{at}cmmc.nhs.uk


  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.

Key Words: EPS • immunosuppression • tamoxifen • transplantation

Received for publication January 29, 2008. Accepted for publication July 14, 2008.


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