Korean J Nephrol.
2009 Nov;28(6):685-692.
Successful Treatment of Sclerosing Encapsulating Peritonitis with Tamoxifen and Prednisolone
- Affiliations
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- 1Department of Internal Medicine, College of Medicine Chungnam National University, Daejeon, Korea. kwlee@cnu.ac.kr
- 2Department of Pathology, College of Medicine Chungnam National University, Daejeon, Korea.
Abstract
- Sclerosing encapsulating peritonitis (SEP) is an uncommon but serious complication of long-term peritoneal dialysis (PD). Entrapment of the intestine in fibrous tissue, causing complete intestinal obstruction, is referred to as SEP. The usual clinical presentation is with partial or complete small bowel obstruction, ascites, abdominal mass, or impaired peritoneal ultrafiltration. Conservative treatment carries a poor outcome and surgery has offered variable results. Even though there is no established medical treatment, immunosuppressive drugs, steroid and tamoxifen are often used. Tamoxifen is a nonsteroidal anti-estrogenic drug commonly used in the management of breast cancer. To our knowledge, this is the first case of sclerosing encapsulating peritonitis successfully treated with tamoxifen and prednisolone in Korea. Recently, we have treated three SEP patients with tamoxifen and prednisolone. All three patients showed clinical improvement within a few months.
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