Tamoxifen for retroperitoneal fibrosis

Frankart, L.; Lorge, Francis; Donckier, Julian

doi:10.1136/pgmj.73.864.653

Cited by 16 publications

(7 citation statements)

References 10 publications

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“…Tamoxifen has been effective in retroperitoneal fibrosis [12,[25][26][27]. Its mechanism of action is unknown, but it has been suggested that it may exert an anti-fibrotic action through the reduction of TGF-b expression [28,29] There are anecdotal reports of the beneficial effect of tamoxifen on EPS and many of these describe its use combined with glucocorticoids [30].…”

Section: Discussionmentioning

confidence: 99%

Encapsulating peritoneal sclerosis: a single-center experience and review of the literature

et al. 2010

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Encapsulating peritoneal sclerosis (EPS) is a serious and often fatal complication of long-term PD with severe malnutrition and poor prognosis. It causes progressive obstruction and encapsulation of the bowel. This retrospective study reviews our experience and that reviewed in the literature concerning EPS. It refers to a total of 1966 patients treated with chronic PD between 1974 and 2008. Twenty one of them (1.1%) developed EPS, with the incidence increasing with the duration of PD. Mean age of our patients with EPS was 43, ranging from 18 to 71 years, 8 were men and 13 women with a mean body mass index (BMI) of 21.6 kg/m(2). Only one patient had Type II diabetes, 15 patients had glomerular disease, and six of these 15 had an autoimmune disease such as Wegener's granulomatosis and SLE. Thirteen patients developed EPS while on PD, 7 within 2 years after transfer to HD, and only one after renal transplantation. However, 7 patients had a previous renal transplant before returning to PD and subsequently developing EPS. Interestingly, we did not observe more episodes of EPS after transplantation. In the patients who developed EPS, the peritonitis rate over the period of observation was 1/15.6 pt-months and was due to Staphylococcus aureus, coagulase-negative staphylococcus, Pseudomonas and fungi. A history of peritonitis was not a prerequisite for developing EPS, since one patient had no episodes of peritonitis and 4 had just one previous episode. Fifteen patients presented with peritonitis within 4 months before the diagnosis of EPS with particularly virulent micro-organisms such as S. aureus, Candida, Pseudomonas, Corynebacterium, and Peptostreptococcus. Eleven patients were treated with hypertonic dextrose solutions (4.25 g/dl of dextrose) and seven with icodextrin, indirectly suggesting problems with ultrafiltration. Nine of 21 patients were on beta-blockers. The diagnosis of EPS was made either surgically or radiologically with signs of small bowel obstruction in combination with severe malnutrition. Eleven of our patients (52%) had evidence of small bowel obstruction and 14 patients required total parenteral nutrition (TPN). Tamoxifen (10-20 mg daily) was started in 6 patients, 4 of whom are alive and 2 deceased 3 and 5 years after EPS was diagnosed. Of the 12 patients who were not given tamoxifen, 2 are alive and 10 died. No side effects of tamoxifen were reported. Only 7 of our patients (33%) died during the first year after the diagnosis of EPS. Currently, 4 patients are on HD and 3 have had a renal transplant. Six patients of the fourteen who underwent surgery (42.8%) died within the first 6 months after operation and five died after an average of 6.6 years, mostly due to cardiovascular causes, three are still alive. As EPS becomes more prevalent with longer duration of PD, large multicenter prospective studies are needed to establish its incidence and identify risk factors, therapeutic approach, and prognosis.

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Section: Discussionmentioning

confidence: 99%

Encapsulating peritoneal sclerosis: a single-center experience and review of the literature

et al. 2010

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“…It has, however, been widely reported as successful in the treatment of retroperitoneal fibrosis [36][37][38], but how well this translates to EPS is unclear. A recent report of its 'prophylactic' use in 9 cases of peritoneal sclerosis showed that none developed EPS, while in the control group of 14 patients with sclerosis 4 developed the syndrome and 3 died [39].…”

Section: Discussionmentioning

confidence: 99%

Single-center experience of encapsulating peritoneal sclerosis in patients on peritoneal dialysis for end-stage renal failure

Summers

Clancy

Syed

et al. 2005

Kidney International

137

131

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“…Steroids are first line therapy if there is no evidence of any mass effect such as compression of surrounding structure, vascular extension into the surrounding veins and arteries, tubular compression like ureters or organ function compromise. Steroid resistant disease can be treated by other immunosuppressive agents including cyclophosphamide, methotrexate, mycophemolate mofetil [21] colchicine [22] and tamoxifen [23].…”

Section: Discussionmentioning

confidence: 99%

Deep Vein Thrombosis /Pulmonary Embolism in a Patient with Retroperitoneal Fibrosis: A Case Report

Agrawal¹

2012

J Clin Case Rep

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Introduction: Retroperitoneal Fibrosis (RPF) is a clinicopathological condition characterized by inflammatory fibrotic reaction around infrarenal aorta, iliac vessels and surrounding retroperitoneum with myriad presentations. This case report shows how a Deep Vein Thrombosis (DVT) and subsequent Pulmonary Embolism (PE) can be a potential complication of this disease. A potential temporal association was seen with chronic beta blocker use and retroperitoneal fibrosis.

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Tamoxifen for retroperitoneal fibrosis

Cited by 16 publications

References 10 publications

Encapsulating peritoneal sclerosis: a single-center experience and review of the literature

Encapsulating peritoneal sclerosis: a single-center experience and review of the literature

Single-center experience of encapsulating peritoneal sclerosis in patients on peritoneal dialysis for end-stage renal failure

Deep Vein Thrombosis /Pulmonary Embolism in a Patient with Retroperitoneal Fibrosis: A Case Report

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