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Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature

BACKGROUND: Overt eosinophilic peritonitis (EP) is a relatively uncommon complication of peritoneal dialysis (PD), although not rare. Here we reported a case of EP relieved after changing dialysate.  CASE PRESENTATION: A 28-year old male patient developed cloudy PD effluents within the first month a...

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Autores principales: Qingyan, Zhang, Yangyang, Xia, Miao, Zhang, Chunming, Jiang
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838006/
https://www.ncbi.nlm.nih.gov/pubmed/36635670
http://dx.doi.org/10.1186/s12882-022-03027-8
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author Qingyan, Zhang
Yangyang, Xia
Miao, Zhang
Chunming, Jiang
author_facet Qingyan, Zhang
Yangyang, Xia
Miao, Zhang
Chunming, Jiang
author_sort Qingyan, Zhang
collection PubMed
description BACKGROUND: Overt eosinophilic peritonitis (EP) is a relatively uncommon complication of peritoneal dialysis (PD), although not rare. Here we reported a case of EP relieved after changing dialysate.  CASE PRESENTATION: A 28-year old male patient developed cloudy PD effluents within the first month after PD started. Cytological study of PD effluents showed elevated white blood cells and polynuclear cells. Bacteria culture of PD effluents repeated for several times were all negative, and no pathogen was found by metagenomics next generation sequencing (mNGS). Antibiotic therapy for 28-day was ineffective. Based on these and increased eosinophils in peritoneal fluid, he was finally diagnosed as EP. PD dialysate was changed (consists of the same buffer agent and electrolytes, but is packed in bags that do not contain PVC), and the patient’s PD effluent became clear. Of note, EP did not relapse 5 months later when the patient started to use the former PD solution again. CONCLUSION: Although PD effluent turbidity almost always represents infectious peritonitis, there are other differential diagnoses including EP. For patients with cloudy fluid accompanied by mild symptoms who do not response to antibiotic therapy, it is reasonable to consider the possibility of this disease. EP tends to heal spontaneously, however, antihistamines or glucocorticoids are required sometimes to avoid catheter obstruction. For patients with no obvious incentives, replacement of dialysate may be useful.
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spelling pubmed-98380062023-01-14 Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature Qingyan, Zhang Yangyang, Xia Miao, Zhang Chunming, Jiang BMC Nephrol Case Report BACKGROUND: Overt eosinophilic peritonitis (EP) is a relatively uncommon complication of peritoneal dialysis (PD), although not rare. Here we reported a case of EP relieved after changing dialysate.  CASE PRESENTATION: A 28-year old male patient developed cloudy PD effluents within the first month after PD started. Cytological study of PD effluents showed elevated white blood cells and polynuclear cells. Bacteria culture of PD effluents repeated for several times were all negative, and no pathogen was found by metagenomics next generation sequencing (mNGS). Antibiotic therapy for 28-day was ineffective. Based on these and increased eosinophils in peritoneal fluid, he was finally diagnosed as EP. PD dialysate was changed (consists of the same buffer agent and electrolytes, but is packed in bags that do not contain PVC), and the patient’s PD effluent became clear. Of note, EP did not relapse 5 months later when the patient started to use the former PD solution again. CONCLUSION: Although PD effluent turbidity almost always represents infectious peritonitis, there are other differential diagnoses including EP. For patients with cloudy fluid accompanied by mild symptoms who do not response to antibiotic therapy, it is reasonable to consider the possibility of this disease. EP tends to heal spontaneously, however, antihistamines or glucocorticoids are required sometimes to avoid catheter obstruction. For patients with no obvious incentives, replacement of dialysate may be useful. BioMed Central 2023-01-12 /pmc/articles/PMC9838006/ /pubmed/36635670 http://dx.doi.org/10.1186/s12882-022-03027-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Qingyan, Zhang
Yangyang, Xia
Miao, Zhang
Chunming, Jiang
Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title_full Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title_fullStr Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title_full_unstemmed Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title_short Peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
title_sort peritoneal dialysis related eosinophilic peritonitis: a case report and review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9838006/
https://www.ncbi.nlm.nih.gov/pubmed/36635670
http://dx.doi.org/10.1186/s12882-022-03027-8
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