case_images: PMC11250623_01
case_images: Course of inflammatory markers and serum lipase in relation to management. Diagnosis of PD peritonitis with CRP 250 mg/L and dialysate leucocyte count 1,047/muL. Diagnosis of acute pancreatitis via markedly elevated lipase (628 U/L, ULN 78 U/L) and abdominal CT scan. Note inflammatory markers before admission due to exit site infection treated with doxycycline. CRP, C-reactive protein.
case_images: cnd-2024-0014-0001-539185_F01.jpg
case_images: PMC11250623_01_cnd-2024-0014-0001-539185_F01.jpg
case_images: F1
case_images: Serum white blood count was 26.000/microL (upper limit of normal [ULN] 9.600/microL), and C-reactive protein was 250 mg/L (ULN 5 mg/L) (Fig. 1). Dialysate cultures remained negative (sampled on day 1, 4, 8, 14, 17, 28, and 36), and effluent leucocyte count remained high (Fig. 1). Systemic and effluent markers of inflammation took 4 weeks to normalize (Fig. 1), and the patient did not regain his usual state of health until several weeks after discharge. Ten weeks later, PD with icodextrin was restarted without complications (Fig. 1).
case_images: CT scan - diagnosis of acute pancreatitis. Notice enlarged pancreas with fluid collections.
case_images: cnd-2024-0014-0001-539185_F02.jpg
case_images: PMC11250623_01_cnd-2024-0014-0001-539185_F02.jpg
case_images: F2
case_images: Diagnosis of acute pancreatitis was established on the basis of CT scan showing an enlarged pancreas surrounded by fluid collections (Fig. 2) and elevated serum lipase (628 U/L, ULN 78 IU/L) (Fig. 1).
case_images: CT scan - 6 weeks follow-up. Notice pancreatic parenchymal necrosis and pseudocyst (arrow).
case_images: cnd-2024-0014-0001-539185_F03.jpg
case_images: PMC11250623_01_cnd-2024-0014-0001-539185_F03.jpg
case_images: F3
case_images: Follow-up CT scan after 6 weeks showed considerable pancreatic sequelae (a pseudocyst, calcification, parenchymal necrosis, Fig. 3).