Kwak Kyoung Min, Choi Gwang Ho, Shim Kwang Eon, Jin Ho Yong, Kim Seok Hyung, Yoon Jong Woo, Kim Hyunsuk
Department of Internal Medicine, Hallym University Medical Center, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea.
Electrolyte Blood Press. 2020 Dec;18(2):44-48. doi: 10.5049/EBP.2020.18.2.44. Epub 2020 Dec 28.
Encapsulating peritoneal sclerosis (EPS) is a potentially fatal complication after long-term peritoneal dialysis, and tamoxifen can be used for its prevention and treatment. However, tamoxifen is known to increase the risk of venous thromboembolism. A 49-year-old woman was admitted with sudden abdominal pain. The patient had received peritoneal dialysis for 20 years and switched to hemodialysis after the diagnosis of EPS. Tamoxifen (10mg) and prednisolone (20mg) had been administered for 8 months. On computed tomography, the left hepatic lobe was hardly illuminated, leading to a diagnosis of liver infarction. A month later, she was re-admitted due to abdominal pain and extensive deep vein thrombosis of the leg. The administration of tamoxifen was stopped and prednisolone was reduced to 10mg. As her malnutrition progressed, she succumbed to death of gram negative sepsis. The patient was concluded to have liver infarction and extensive venous thrombosis as a side effect of tamoxifen.
包裹性腹膜硬化症（EPS）是长期腹膜透析后一种潜在的致命并发症，他莫昔芬可用于其预防和治疗。然而，已知他莫昔芬会增加静脉血栓栓塞的风险。一名49岁女性因突发腹痛入院。该患者接受腹膜透析20年，在诊断为EPS后转为血液透析。他莫昔芬（10mg）和泼尼松龙（20mg）已服用8个月。在计算机断层扫描中，左肝叶几乎没有显影，导致诊断为肝梗死。一个月后，她因腹痛和腿部广泛深静脉血栓形成再次入院。停用他莫昔芬，泼尼松龙减至10mg。随着她营养不良的进展，她死于革兰氏阴性菌败血症。该患者被判定患有肝梗死和广泛静脉血栓形成，为他莫昔芬的副作用。
