Systemic Lupus Erythematosus as a Risk Factor for Encapsulating Peritoneal Sclerosis: A Case Report

Encapsulating peritoneal sclerosis (EPS) refers to the insidious formation of a thick fibrous cocoon encasing the intra-abdominal organs and may lead to bowel obstruction. EPS is a known but rare complication of chronic peritoneal dialysis (PD) due to the long-term exposure of glucose degradation products and recurrent peritonitis, promoting inflammatory fibrosis and sclerosis of intra-abdominal structures. However, PD patients with systemic lupus erythematosus (SLE) may be at increased risk of developing EPS due to the concurrent immune-mediated inflammation of the peritoneal serosa. This report describes the case of a young female with SLE and end-stage renal disease (ESRD) due to lupus nephritis who developed EPS after five years of PD. Her clinical course was complicated by septic shock and pneumoperitoneum; exploratory laparotomy revealed diffuse fibrous encapsulation of the liver, transverse colon, and stomach requiring surgical enterolysis. This case highlights the role of SLE as an important risk factor for EPS and underscores the need for preventive measures among this high-risk population of chronic PD patients.