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Peritoneal sclerosis

Jun Li Tsai, Ming Ju Wu, Cheng Hsu Chen, Shang Feng Tsai
INTRODUCTION: Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis (PD). Tamoxifen has been generally well-tolerated, even without randomized controlled trials. CASE PRESENTATION: Herein, we report a case of a patient undergoing 12 years of PD who developed EPS and calciphylaxis simultaneously. We also provide a comprehensive discussion about the association between EPS and calciphylaxis. Moreover, although tamoxifen is used in EPS due to its inhibition of fibroblast-transforming growth factor beta (TGFβ) production, it may worsen the calciphylaxis due to a hypercoagulable state...
August 2016: Iranian Red Crescent Medical Journal
Sudabeh Alatab, Iraj Najafi, Gholamreza Pourmand, Mostafa Hosseini, Soroosh Shekarchian
Peritoneal dialysis (PD) offers the healthiest way for starting renal replacement therapy (RRT) in End Stage Renal Disease patients, however exposes long-term PD patients to a dangerous complication named encapsulating peritoneal sclerosis (EPS). In this study, we searched for possible risk factors of EPS. Data were collected from two PD centers covering period 1995-2012 and comprised 464 patients. Control group defined as PD patients stayed on PD >42 month (n = 122), and case group was 12 confirmed EPS patients...
October 24, 2016: Renal Failure
J-B Monfort, I Lazareth, P Priollet
OBJECTIVE: Association between cancer and systemic sclerosis (SSc) has been described. However, paraneoplastic SSc is not well known. The aim of this article is to describe cases of paraneoplastic systemic sclerosis and to compare them to other cases of the literature, to find characteristics that can make suspect a paraneoplastic mechanism when SSc is diagnosed. METHODS: We retrospectively analyzed patients, in our department who, over the last 15 years, presented with Raynaud's phenomenon with a diagnosis of SSc (including cancer during the period of SSc)...
October 14, 2016: Journal des Maladies Vasculaires
Alexandre Minetto Brabo, Nayrana Soares Do Carmo Reis, Pasqual Barretti, Daniela Ponce
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis that carries a high morbidity and mortality. Although its pathogenesis is still not clear, the "two hit theory" suggests that long term deterioration of the peritoneum combined with intraperitoneal inflammation is needed in the pathogenesis of EPS. To date, there is no proven effective therapy with an absence of randomized controlled trials. Individual case reports and small case series have reported on the use of tamoxifen and corticosteroids for medical management of EPS...
October 9, 2016: Hemodialysis International
Tahere Sadat Kalantarian, Iraj Najafi
After 20 years of peritoneal dialysis in Iran, we have encountered with several cases of encapsulating peritoneal sclerosis (EPS) in past few years. Many of these cases remained undiagnosed until advanced stages due to lack of suspicion. In centers with more experience about EPS, mortality has decreased by early diagnostic interventions. Peritoneal dialysis nurses may not be aware of EPS and radiologists are usually not familiar with EPS, either. To increase knowledge about this condition, we decided to present this review article with the case study of one of the 1st patients with EPS at our center...
September 2016: Iranian Journal of Kidney Diseases
Masataka Banshodani, Hideki Kawanishi, Misaki Moriishi, Sadanori Shintaku, Shinji Hashimoto, Shinichiro Tsuchiya
Surgical enterolysis is the final option for patients with encapsulating peritoneal sclerosis (EPS). However, EPS is sometimes refractory to surgical enterolysis. This is the first report of successful use of percutaneous endoscopic gastrostomy with jejunal extension (PEG-J) in a patient with EPS that was refractory to surgical enterolysis. We propose that sustained drainage of digestive juices by PEG-J, along with central venous nourishment at home, can be a treatment option for patients with EPS that cannot be treated with radical measures...
September 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Manabu Kaneko, Shin Sasaki, Shuzo Teruya, Kosuke Ozaki, Kazuhiro Ishimaru, Emi Terai, Hiroshi Nakayama, Toshiyuki Watanabe
Pneumatosis cystoides intestinalis (PCI) is a rare gastrointestinal complication of systemic sclerosis (SSc) characterized by intramural accumulation of gas within thin-walled cysts. We report the case of an 82-year-old female patient with pneumoperitoneum due to PCI associated with SSc and review the features of the 39 Japanese cases. The median patient age was 57 years (range 24-83 years) and the male/female ratio was 1 : 12. In the recent decade, 14 out of 15 cases (93.3%) evaluated with CT scans were diagnosed with PCI...
2016: Case Reports in Gastrointestinal Medicine
Genta Kanai, Takatoshi Kakuta, Takashi Hirukawa, Chizuko Okamatsu, Masafumi Fukagawa
We report a case of peritoneal mesothelioma discovered in a patient during peritoneal dialysis. The patient was a 55-year-old woman who had no history of asbestos exposure. Owing to end-stage kidney failure, she had been undergoing peritoneal dialysis for over 8 years, and she had been diagnosed with encapsulating peritoneal sclerosis. She was admitted to the hospital for intestinal obstruction. Three months later, she noticed an enlarging mass in the epigastric region. Computed tomography showed a 10-cm mass originating in the abdominal wall that had invaded the liver...
2016: Tokai Journal of Experimental and Clinical Medicine
Andrzej Ratajczak, Małgorzata Lange-Ratajczak, Adam Bobkiewicz, Adam Studniarek
This report reviews the most common surgical interventions and complications of chronic peritoneal dialysis (PD) patients. Based on the current knowledge as well as our experience we detail the role of these surgical procedures. We supplement the reported knowledge in the field with our own experience in this area. The areas discussed include early complications such as surgical wound hemorrhage, bleeding from the catheter, intestinal perforation and urinary bladder perforation, dialysate leakage through the wound, as well as late complications including catheter kinking or occlusion, retention of fluid in the peritoneal recess, hernias and hydrothorax, and encapsulating peritoneal sclerosis...
September 6, 2016: Seminars in Dialysis
Jana Enderes, Julia van der Linde, Jan Müller, Bich-Thu Tran, Wolfram von Bernstorff, Claus-Dieter Heidecke, Tobias Schulze
BACKGROUND: FTY720 is an immunosuppressive molecule licensed for the treatment of chronic relapsing multiple sclerosis (MS). It attenuates the adaptive immune response by sequestering T cells within secondary lymphoid organs via its action as functional antagonist of sphingosine-1-phasphate. To date it is unknown whether FTY-induced lymphopenia puts MS patients at increased risk for severe forms of postoperative infectious complications such as abdominal sepsis. OBJECTIVES: To determine the effect of FTY720-induced lymphopenia on survival to sepsis secondary to postoperative intraabdominal infections in a murine model of polymicrobial sepsis...
August 24, 2016: Shock
Masatsugu Nakao, Izumi Yamamoto, Yukio Maruyama, Masamitsu Morishita, Akio Nakashima, Nanae Matsuo, Yudo Tanno, Ichiro Ohkido, Masato Ikeda, Hiroyasu Yamamoto, Keitaro Yokoyama, Takashi Yokoo
AIM: Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication that occurs in peritoneal dialysis (PD) therapy. The present study aimed to identify the risk factors, especially peritonitis and biocompatible PD fluid. METHODS: The study included 703 patients who received PD between January 1980 and March 2015 at two centers. The patients were divided into two groups: those who had developed EPS (EPS group: n = 44) and those who had no documentary evidence of EPS (non-EPS group: n = 659)...
August 24, 2016: Nephrology
Daniel Kitterer, Niko Braun, M Dominik Alscher, Stephan Segerer, Joerg Latus
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is the most severe complication associated with long-term peritoneal dialysis (PD). Previous studies noticed a sharp decline in new patients with severe EPS. We investigated the number of severe EPS patients in our large referral center over almost 20 years. METHODS: All late-stage EPS patients who underwent major surgery due to extensive symptoms caused by bowel obstruction (vomiting, abdominal pain, and weight loss) between March 1997 and end of December 2015 in our hospital were included in the present study...
2016: International Journal of Nephrology and Renovascular Disease
Leandro A Lobo, Claudia F Benjamim, Ana Carolina Oliveira
Mammals harbor a complex gut-associated microbiota, comprising bacteria that provide immunological, metabolic and neurological benefits to the host, and contribute to their well-being. However, dysregulation of the microbiota composition, known as dysbiosis, along with the associated mucosal immune response have a key role in the pathogenesis of many inflammatory diseases, including inflammatory bowel diseases (IBDs), type 1 and type 2 diabetes, asthma, multiple sclerosis, among others. In addition, outside the gut lumen, bacteria from microbiota are the causative agent of peritoneal inflammation, abdominal sepsis and systemic sepsis...
July 2016: Clinical & Translational Immunology
Michaela C Petrie, Jamie P Traynor, Robert A Mactier
BACKGROUND: Studies report variation in the incidence and outcomes of encapsulating peritoneal sclerosis (EPS). This study reports the incidence and outcome of EPS cases in a national cohort of peritoneal dialysis (PD) patients. METHODS: The incident cohort of adult patients who started PD between 1 January 2000 and 31 December 2007 in Scotland (n = 1238) was identified from the Scottish Renal Registry. All renal units in Scotland identified potential EPS cases diagnosed from 1 January 2000 to 31 December 2014, by which point all patients had a minimum of 7 years follow-up from start of PD...
August 2016: Clinical Kidney Journal
Maryam Ghadimi, Simin Dashti-Khavidaki, Hossein Khalili
BACKGROUND: Encapsulating peritoneal sclerosis (EPS) is an infrequent, serious complication of peritoneal dialysis (PD). EPS may develop after kidney transplantation of PD-treated patients possibly due to the fibrotic effect of calcineurin inhibitors (CNIs). Some experimental and clinical studies proposed inhibitors of mammalian target of rapamycin (mTOR) for EPS management due to their anti-fibrotic and anti-angiogenesis effects. This review evaluated the therapeutic role of mTOR inhibitors in the management of EPS...
July 17, 2016: Renal Failure
Martha Gschwandtner, Anna Maria Piccinini, Tanja Gerlza, Tiziana Adage, Andreas J Kungl
Multiple Sclerosis, a chronic inflammatory demyelinating disease of the central nervous system, involves an increased expression of monocyte chemotactic protein 1 MCP1-/CCL2. For exerting its chemotactic effects, chemokine binding to glycosaminoglycans (GAGs) is required and therefore this interaction represents a potential target for therapeutic intervention. We have designed an anti-inflammatory decoy variant, Met-CCL2 (Y13A S21K Q23R), embodying increased affinity for GAGs as well as knocked-out GPCR activation properties...
July 28, 2016: Neuroscience Letters
Alena Parikova, Anniek Vlijm, Irena Brabcova, Marijke de Graaff, Dirk G Struijk, Ondrej Viklicky, Raymond T Krediet
♦ BACKGROUND: Permanent stimulation of the peritoneum during peritoneal dialysis (PD) is likely to result in increased expression of genes encoding proteins involved in inflammation and tissue remodeling. Peritoneal fibrosis and neoangiogenesis may develop. ♦ OBJECTIVE: To assess highly expressed genes potentially in volved in peritoneal alterations during PD treatment using an animal model. ♦ METHODS: A PD catheter was implanted in 36 male Wistar rats after 70% nephrectomy. The rats were divided into 3 groups, exposed to dialysis solution for 8 weeks, and sacrificed 2 weeks later...
November 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Mitsuhiro Tawada, Yasuhiko Ito, Chieko Hamada, Kazuho Honda, Masashi Mizuno, Yasuhiro Suzuki, Fumiko Sakata, Takeshi Terabayashi, Yoshihisa Matsukawa, Shoichi Maruyama, Enyu Imai, Seiichi Matsuo, Yoshifumi Takei
BACKGROUND AND OBJECTIVES: Encapsulating peritoneal sclerosis (EPS) is a rare but serious and life-threatening complication of peritoneal dialysis (PD). However, the precise pathogenesis remains unclear; in addition, predictors and early diagnostic biomarkers for EPS have not yet to be established. METHODS: Eighty-three peritoneal membrane samples taken at catheter removal were examined to identify pathological characteristics of chronic peritoneal deterioration, which promotes EPS in patients undergoing long-term PD treatment with low occurrence of peritonitis...
2016: PloS One
Gioacchino Li Cavoli, Angelo Tralongo, Nazzarena Arena, Baldassare Scaturro, Filippo Carollo, Tancredi Vincenzo Li Cavoli, Pietro Tralongo, Ugo Rotolo
Encapsulating peritoneal sclerosis (EPS) is a rare and life-threatening complication of long-term peritoneal dialysis and until now, there is no established medical treatment for it. Many factors have been incriminated in its pathogenesis but they do not explain all risk conditions. EPS is significantly associated with PD duration, particularly more than 5 years, however the relationship between long-term PD and EPS increased risk is currently unknown. The "two-hit hypothesis" analyzes the relationship between the histological changes Peritoneal Dialysis-induced and intercurrent acute inflammatory episodes, but it does not explain the transition from Sclerosis Simple to EPS...
March 2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Divya G Moodalbail, Leah Z Apple, Kevin E Meyers, Jill P Ginsberg, Bernard S Kaplan, Richard Bellah
Cystic kidney disease includes a wide range of hereditary, developmental, and acquired conditions of the kidneys. Some of the inherited causes of cystic kidney disease include autosomal dominant polycystic kidney diseases (caused by mutations in PKD1 or PKD2), autosomal recessive polycystic kidney disease, tuberous sclerosis complex, von Hippel-Lindau disease, oral-facial-digital syndrome type I, and Hadju-Cheney syndrome. Acquired cystic kidney disease has been reported in patients receiving long-term hemodialysis or peritoneal dialysis and in children after liver transplantation...
July 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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