A patient with sclerosing encapsulating peritonitis (SEP) successfully treated by steroid pulse therapy

key words: 腹膜透析, 硬化性被嚢性腹膜炎, イレウス, ステロイ ド療法 <要旨> 症例は42歳 男性. 1985年1月 末期慢性腎不全のため当院にてCAPD療 法導入. 以降当院外来通院中であった. 1996年8月15日 頃より食後の吐気嘔吐繰 り返すようにな り食欲低下, 1週 間に5kgの 体重減少を認めていた. 同 21日 腹痛排液混濁認め翌22日 来院. 細胞数361個/μl, CRP26.3mg/dl, 白血球14100/μlで あ りCAPD腹 膜炎 の診断で緊急入院 となった. 入院時理学的所見 および画像診断にて硬化性被嚢性腹膜炎 (sclerosing encapsulating peritonitis: SEP) と診断 し, 禁飲食, 鼻腔胃チューブによる腸閉塞 に対する対処 とメチルプ レドニゾロン1000mg のステロイ ドパルス療法を施行 し腸管癒着の改善 と経 口摂取可能な までに回復を認めた. 早急な対応 とステロイ ド 療法がSEPに 有効であったと考えられここに報告する.

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