Acute-onset, steroid-sensitive, encapsulating peritoneal sclerosis in a renal transplant recipient

Encapsulating peritoneal sclerosis is a severe complication of peritoneal dialysis. Immunosuppressive drugs have been claimed to be helpful in the treatment of this disease, although the pathophysiological background is poorly understood. In this report, we present a patient with encapsulating peritoneal sclerosis after successful renal transplantation. Maintenance immunosuppressive therapy consisted of mycophenolate mofetil, tacrolimus, and low-dose corticosteroids. The patient was treated successfully with high doses of corticosteroids. A subsequent relapse of the encapsulating peritoneal sclerosis, probably resulting from fast tapering of the corticosteroid dose, responded well to an increase in corticosteroid dose. Our case strongly supports a therapeutic role for high-dose steroids in the treatment of encapsulating peritoneal sclerosis during its initial inflammatory stage.