Eosinophilic peritonitis in children on chronic peritoneal dialysis
- PDF / 601,445 Bytes
- 7 Pages / 595.276 x 790.866 pts Page_size
- 66 Downloads / 225 Views
ORIGINAL ARTICLE
Eosinophilic peritonitis in children on chronic peritoneal dialysis Ryutaro Suzuki 1 & Mai Sato 1 & Miki Murakoshi 1 & Chikako Kamae 1 & Toru Kanamori 1 & Kentaro Nishi 1 & Masao Ogura 1 & Koichi Kamei 1 Received: 23 July 2020 / Revised: 11 September 2020 / Accepted: 16 October 2020 # IPNA 2020
Abstract Background Eosinophilic peritonitis (EP) is sometimes difficult to distinguish from bacterial peritonitis (BP) at onset, as they are often overlapping. Previous reports show EP occurs more frequently in infants, although the reason is unknown. Methods The study population was 77 pediatric patients receiving chronic peritoneal dialysis (PD) in our center. We compared clinical and laboratory data at onset of EP with those of BP. We also investigated age distribution at onset of EP and PD-related surgery. Results Eleven patients developed EP (18 episodes) and 19 patients developed BP (38 episodes). EP patients showed lower rate of cloudy dialysate (44.4% vs. 74.4%; p = 0.04), lower rate of fever (38.9% vs. 56.4%), lower frequency of abdominal pain (16.7% vs. 38.5%), higher peripheral blood eosinophil counts (/μL) (514 vs. 160; p < 0.001), and lower serum C-reactive protein level (mg/dL) (0.4 vs. 4.7; p < 0.001) than BP patients. Thirteen EP events were observed after 169 surgical interventions. Age at surgery-related EP was similar to age at surgery without EP (2.6 vs. 2.1; p = 0.65). There was no significant difference in postoperative EP occurrence between groups 100 leukocytes per milliliter of dialysate fluid, with > 10% of eosinophils in the total leukocyte count and culture-negative peritonitis. EP is usually described as a benign peritonitis which requires no therapeutic intervention [3]. The occurrence of EP has been reported as ranging from 16 to 60% in patients receiving PD [4, 5]. In most cases, it occurs within a few months after the start of dialysis, but it may occur several years after the start of dialysis [4]. * Koichi Kamei [email protected] 1
Division of Nephrology and Rheumatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo 157-8535, Japan
The detailed mechanism of EP is unknown. However, the main cause of EP is speculated to be an allergic response to chemical or mechanical insults to the peritoneum. Air in the peritoneum [6], intraperitoneally administered medication, including antibiotics [6] and icodextrin administration [7], have been reported as causes of EP. Surgery is one of the major causes of EP and it sometimes occurs within 2 to 4 weeks after surgery [4, 8]. As BP is a severe infection, sometimes life-threatening, prompt initiation of antibiotics is essential. The delay in treatment or treatment failure leads to loss of peritoneal function. However, for EP antimicrobial agents are not necessary, as it usually resolves spontaneously. Therefore, it is important to distinguish cases at the onset of peritonitis. Although differentiation of these two is relatively easy, they are sometimes overlapping, which might be difficult to d
Data Loading...
