Encapsulating Peritoneal Sclerosis in Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Systemic Sclerosis

Intern Med. 2023 Jun 1;62(11):1683-1689. doi: 10.2169/internalmedicine.9793-22. Epub 2022 Oct 26.

Abstract

We encountered a 57-year-old Japanese woman with encapsulating peritoneal sclerosis (EPS) in systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic sclerosis. The patient was admitted to our hospital because of ascites retention. Administration of tocilizumab, an anti-interleukin-6 receptor antibody, for her RA reduced the refractory ascites remarkably; however, she developed sudden acute gastrointestinal bleeding and died a year later. On autopsy, sclerotic thickening of the peritoneum showed diffuse infiltration of podoplanin-positive fibroblast-like cells, and a diagnosis of EPS was made. EPS rarely occurs in SLE, and tocilizumab may be a new treatment candidate for EPS.

Keywords: encapsulating peritoneal sclerosis; podoplanin; rheumatoid arthritis; systemic lupus erythematosus; tocilizumab.

Publication types

  • Case Reports

MeSH terms

  • Arthritis, Rheumatoid* / complications
  • Ascites / complications
  • Female
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Middle Aged
  • Peritoneal Fibrosis* / etiology
  • Scleroderma, Systemic* / complications