Moustafellos P, Hadjianastassiou V, Roy D, Velzeboer N E, Maniakyn N, Vaidya A, Friend P J
Oxford Transplant Unit, Oxford Radcliffe NHS Trust, Oxford, UK.
Transplant Proc. 2006 Nov;38(9):2913-4. doi: 10.1016/j.transproceed.2006.08.179.
Sclerosing encapsulating peritonitis (SEP) is a serious complication of long-term continuous ambulatory peritoneal dialysis (CAPD) associated with obstructive symptoms and sclerosis of the peritoneal membrane. We present two cases that were successfully treated with tamoxifen and corticosteroids. Case 1: A 40-year-old patient developed end-stage renal failure (ESRF) and was managed with CAPD. He was hospitalized with symptoms of small bowel obstruction. He underwent laparotomy confirming the diagnosis of SEP. The patient was given tamoxifen 20 mg twice a day. Case 2: A 55-year-old patient with ESRF secondary to membranous glomerulonephritis. After having a cadaveric renal transplant in 1978 that failed 20 years later, the patient returned to CAPD. Six years later he had an uneventful kidney transplant and the peritoneal dialysis catheter was removed. However, 8 months later he presented with symptoms of small bowel obstruction and gross blood stained ascites. He also underwent a laparotomy that confirmed the diagnosis of SEP after biopsy. The patient was started on 20 mg of tamoxifen twice a day. Both patients' symptoms were improved gradually with an increase of serum albumin and body weight. Tamoxifen may be useful in the treatment of patients diagnosed with SEP.
硬化性包裹性腹膜炎（SEP）是长期持续性非卧床腹膜透析（CAPD）的一种严重并发症，与梗阻症状及腹膜硬化相关。我们报告两例成功使用他莫昔芬和皮质类固醇治疗的病例。病例1：一名40岁患者发展为终末期肾衰竭（ESRF）并接受CAPD治疗。他因小肠梗阻症状入院。他接受了剖腹手术，确诊为SEP。给予患者他莫昔芬20毫克，每日两次。病例2：一名55岁患者因膜性肾小球肾炎继发ESRF。1978年接受尸体肾移植，20年后移植失败，患者重新开始CAPD治疗。六年后他顺利接受肾移植并拔除了腹膜透析导管。然而，8个月后他出现小肠梗阻症状及肉眼血性腹水。他也接受了剖腹手术，活检后确诊为SEP。给予患者他莫昔芬20毫克，每日两次。两名患者的症状均随着血清白蛋白增加和体重上升而逐渐改善。他莫昔芬可能对诊断为SEP的患者治疗有用。
