mycophenolic-acid and Peritoneal-Diseases

Encapsulating peritoneal sclerosis is a rare, but potentially lethal, complication of peritoneal dialysis. Treatment of patients with encapsulating peritoneal sclerosis is controversial. Conservative treatment carries a poor outcome, and immunosuppressive drugs are now used frequently. Most commonly, these immunosuppressive regimens include steroids with or without azathioprine or cyclosporine. Mycophenolate mofetil is a reversible DNA synthesis inhibitor that frequently replaces azathioprine in renal transplantation because of its improved immunosuppressive potency and better side-effect profile. We report 3 cases of encapsulating peritoneal sclerosis in continuous ambulatory peritoneal dialysis patients for which an association of prednisone and mycophenolate mofetil significantly modified the evolution of the disease. All 3 patients showed significant improvement within a month and are still alive more than 2 years after the diagnosis of encapsulating peritoneal sclerosis. None experienced a relapse or abdominal symptoms, and body weights are stable. This is the first report of 3 cases of successful treatment of patients with encapsulating peritoneal sclerosis with prednisone and mycophenolate mofetil.

Topics: Adult; Anti-Inflammatory Agents; Ascites; Ascitic Fluid; Candida glabrata; Candidiasis; Female; Fibrosis; Humans; Immunosuppressive Agents; Intestinal Obstruction; Intestine, Small; Middle Aged; Mycophenolic Acid; Peritoneal Dialysis, Continuous Ambulatory; Peritoneal Diseases; Peritoneum; Peritonitis; Prednisone; Sclerosis; Staphylococcus epidermidis