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Review of the literature and description of a case of sclerosing encapsulating peritonitis requiring home parenteral nutrition

Fragkos, KC; Al-Sulttan, FM; Mookerjee, RP; Winstanley, A; Forbes, A; (2011) Review of the literature and description of a case of sclerosing encapsulating peritonitis requiring home parenteral nutrition. Zeitschrift für Gastroenterologie , 49 (12) 1543 - 1548. 10.1055/s-0031-1281847. Green open access

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Abstract

We present a case of a 48 year old HIV patient, who had recurrent episodes of ascites since 2007. His history includes ischaemic heart disease, for which he was treated with atenolol from 2005 to 2007, and Type 2 diabetes; he was later started on propranolol 40  mg twice a day from 2007 for Didanosine-induced portal hypertension. Because of negative cultures and neutrophil count < 250 cells/μL, spontaneous bacterial peritonitis was excluded. However, some low grade-peritoneal irritation cannot be ruled out because his CRP varied from 24 to 258, during 2007 - 2009, without any other obvious inflammatory cause. He was finally diagnosed in July 2009 with sclerosing encapsulating peritonitis (SEP) based on clinical features of intestinal obstruction, histology and imaging, including computed tomography and magnetic resonance imaging. Propranolol was stopped in November 2009.  Because of the patient's severe intestinal obstruction, he was started on parenteral nutrition 2  L/day. Since then, his CRP has returned to normal levels and there is a great improvement of his clinical features. This case demonstrates beta-blockers as a potential cause of SEP, while the presence of some low-grade peritoneal inflammation leading to SEP is also very likely.

Type: Article
Title: Review of the literature and description of a case of sclerosing encapsulating peritonitis requiring home parenteral nutrition
Location: Germany
Open access status: An open access version is available from UCL Discovery
DOI: 10.1055/s-0031-1281847
Publisher version: http://dx.doi.org/10.1055/s-0031-1281847
Language: English
Keywords: Ascites, Humans, Male, Middle Aged, Parenteral Nutrition, Home, Peritoneum, Peritonitis, Recurrence, Sclerosis, Treatment Outcome
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Inst for Liver and Digestive Hlth
URI: https://discovery.ucl.ac.uk/id/eprint/1328226
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