腹膜透析包覆性腹膜硬化症案例

包囊性腹膜硬化症（encapsulating peritoneal sclerosis, EPS）是腹膜透析病患罕見但死亡率高的併發症。本文以一位長期腹膜透析病患為例，病患符合本院3項EPS高風險因子且臨床表徵有脫水量減少，high sensitivity C-reactive protein（hsCRP）增高與白蛋白降低等，經腹部電腦斷層檢查後確診為EPS。病患轉為血液透析1個月後，雖無腸胃道症狀，但腹水中白血球由19/μL增加至1,127/μL，因此開始給予Prednisone 25 mg/day、Tamoxifen 10 mg Q12H治療，治療後腹膜發炎指數改善且於2022年4月移除Tenckhoff catheter。

關鍵字

包囊性腹膜硬化症；腹膜透析；合併症

並列摘要

Encapsulating peritoneal sclerosis (EPS) is a rare but devastating complication of peritoneal dialysis (PD) with a high mortality rate. Herein, we presented a 47-year-old patient with long-term PD therapy as an example. The clinical manifestations of this patient met two high-risk factors for EPS, including poor ultrafiltration, elevated high sensitivity C-reactive protein (hsCRP), and decreased albumin. This patient was further diagnosed with EPS after an abdominal computed tomography examination and recommended to switch to hemodialysis treatment. After 1 month of hemodialysis treatment, although there is no abdominal pain, vomiting, or indigestion, the WBC increased from 19/ μL to 1,127/μL in ascites. Therefore, the patient was subsequently started on Prednisone 25 mg daily, and Tamoxifen 10 mg Q12H. After we changed the prescription, the clinical symptoms of this patient in the peritoneal inflammation index were ameliorated and the removal of the Tenckhoff catheter was in April 2022.

並列關鍵字

encapsulating peritoneal sclerosis ； peritoneal dialysis ； complications

主題瀏覽