To our knowledge, this is the first case report of post-transplantation check details EPS that has been treated with everolimus. One previous case report suggested favourable use of everolimus for a non transplant, peritoneal dialysis patient who developed EPS.[4] Everolimus, in addition to its immunosuppressive effects through mammalian target of rapamycin (mTOR) inhibition, has well known antiproliferative

properties for which it has been used therapeutically. In rat models, it has been shown to have beneficial effects on reducing peritoneal fibrosis.[5] In this case a combination of treatment modalities, including everolimus, tamoxifen, corticosteroids, stopping CNI, intermittent total parenteral nutrition and surgery, were utilised to result in a successful outcome

for the patient. Surgery was essential in gaining immediate control over life threatening symptoms. However, it is not possible to determine MK0683 cost which of these treatments has had the greatest benefit, as no uniformly successful therapy for EPS exists at present. Tamoxifen is the most studied medical treatment, but to our knowledge, its use has only been reported in small case series of non-transplant patients, and only in case studies of EPS post renal transplantation.[6] Surgical treatments for EPS are reported in larger case series, but recurrence rates are high.[6] The immunosuppressive and antiproliferative properties of everolimus give it a theoretical role for use in the disease. With no effective management for EPS, prospective randomised controlled trials of this rare disease are required. To further investigate the role for everolimus in EPS, one approach would be to randomise patients at high risk of EPS post renal transplantation to standard CNI based immunosuppression versus switch to an everolimus based maintenance immunosuppression. “
“Introduction:  Peritoneal dialysis MycoClean Mycoplasma Removal Kit (PD)-related infections due to rapidly growing nontuberculous mycobacterium (RGNTM) are rare in Asians and have variable clinical outcomes. Methods:  We analysed retrospectively a series of RGNTM

infections in a single-centre multi-ethnic Asian population over a 5-year period. Clinical features, treatment, risk factors and outcomes are discussed. Results:  Ten infections are described. They constituted 3% of all culture-positive exit site infection (ESI) and PD peritonitis. Seventy percent were due to Mycobacterium abscessus (three ESI and four peritonitis). There were two Mycobacterim fortuitum and one Mycobacterium chelonei peritonitis. No specific findings differentiated RGNTM infections from those caused by traditional organisms. Six cases had received prior antibiotics, two being topical gentamicin. Initial routine culture and alcohol acid fast bacillus were negative except for one case of M. abscessus. A confirmatory diagnosis was made a median 9 days post culture. No infection responded to routine antibiotics.