| [ Summary ] |
Encapsulating peritoneal sclerosis (EPS) is characterized by encapsulization of the intestines in a thin membrane, which is derived from fibrin. Increased exudation of inflammatory mediators and coagulation factors from the intestinal serosa and their accumulation on the peritoneum are important for encapsulating membrane formation. Histologically, fibrin exudation, perivascular bleeding, peritoneal fibroblast swelling and proliferation were frequently observed in EPS. The peritoneal fibroblast showed increased expression of alphaSMA, FGF and its receptor (bek) and MIF. Mib-1 and bcl2 were also expressed in some of the fibroblasts of EPS patients. These findings were useful markers for EPS. To prevent EPS, peritoneal leavage after discontinuation of CAPD should be continued until peritoneal inflammation disappears. A follow-up estimation of the peritoneal membrane biopsy is necessary for prevention of EPS, in combination with other inflammatory markers in the serum and the peritoneal effluent. |