Early Diagnosis and Effective Therapy for Encapsulating Peritoneal Sclerosis After Renal Transplantation: A Case Study

Encapsulating peritoneal sclerosis (EPS) is a rare but severe complication of long-term peritoneal dialysis. Characterized by thickening of the peritoneal membrane, EPS leads to bowel encapsulation, ultrafiltration failure, and bowel obstruction. This study describes the case of a 61-year-old man with a history of hypertension and end stage renal disease requiring peritoneal dialysis for ten years who developed EPS after cadaveric renal transplantation. The patient experienced recurrent episodes of abdominal distension, ascites, and ileus starting 10 days after transplantation. Diagnostic imaging and histological examination confirmed EPS, as defined by a podoplanin score of 2 with diffuse accumulation of podoplanin-positive fibroblastic cells in the peritoneal membrane. Early intervention with corticosteroids and tamoxifen led to gradual improvement and stabilization of his condition. This case not only emphasizes the importance of early diagnosis of EPS but also highlights the importance of timely treatment to promote favorable outcomes for patients with this potentially devastating disease.