Sclerosing peritonitis and propranolol.

Area of Science:

• Cardiology
• Gastroenterology
• Pharmacology

Background:

• Beta-adrenergic receptor antagonists, such as propranolol, are widely used for cardiovascular conditions like angina pectoris.
• Sclerosing peritonitis is a rare but serious condition characterized by inflammation and fibrosis of the peritoneum.
• The association between beta-blocker therapy and sclerosing peritonitis is not well-established, with limited reported cases.

Observation:

• A 43-year-old male patient with angina pectoris developed symptoms including abdominal and back pain, weight loss, abdominal fullness, ascites, and partial small bowel obstruction.
• The patient was undergoing treatment with propranolol, a beta-adrenergic receptor antagonist.
• Surgical examination revealed a distended small bowel encased in dense fibrous tissue, indicative of sclerosing peritonitis.

Findings:

• Infectious and neoplastic etiologies for the fibrosing peritoneal inflammation were ruled out.
• The clinical presentation and surgical findings were consistent with sclerosing peritonitis.
• This case presents features commonly seen in drug-induced sclerosing peritonitis associated with beta-adrenergic blockade therapy.
• Notably, the development of ascites and significant ascitic fluid leukocytosis were observed, which have not been previously reported in this context.

Implications:

• This case underscores the potential for beta-adrenergic receptor antagonists, specifically propranolol, to induce sclerosing peritonitis.
• The findings suggest that clinicians should consider drug-induced causes in patients presenting with symptoms of sclerosing peritonitis, especially those on beta-blocker therapy.
• The novel observation of ascites and leukocytosis in this context warrants further investigation into the pathogenesis and diagnostic markers of drug-induced sclerosing peritonitis.