BACKGROUND AND OBJECTIVES: Cyst infection and cyst hemorrhage are frequent and serious complications of autosomal dominant polycystic kidney disease (ADPKD), often being difficult to diagnose and treat. The first objective of this study is to clarify the clinical features of ADPKD patients with cyst hemorrhage or infection. The second objective is to establish diagnostic criteria for ADPKD patients with cyst infection or cyst hemorrhage. PATIENTS AND METHODS: Patients with definite cyst infection or hemorrhage were enrolled from among the ADPKD patients referred to us between January 2004 and October 2011. We investigated their symptoms, laboratory data, and the computed tomography (CT)/magnetic resonance imaging (MRI) features of infected cysts (before and after onset), normal cysts, and cysts with hemorrhage. RESULTS: There were 24 patients with cyst infection (36 infected cysts) and 12 patients with acute cyst hemorrhage (13 bleeding cysts). White blood cell (WBC) count >10,000/μl, serum C-reactive protein (CRP) >15.0 mg/dl, and body temperature >38 °C strongly suggested cyst infection. All of the cysts with hemorrhage contained a high-density mass-like area or showed overall high density on CT, and all patients with cyst hemorrhage had abdominal pain or gross hematuria. On the other hand, infected cysts showed an increase of intensity on MRI [diffusion-weighted imaging (DWI)], while a fluid-fluid level, wall thickening, and gas were also evidence of infection. Abdominal pain and/or sequential changes on MRI after onset of symptoms were useful for localizing infected cysts. CONCLUSION: Acute cyst hemorrhage and infection can be identified from symptoms, laboratory data, and CT/MRI findings.
BACKGROUND AND OBJECTIVES:Cyst infection and cyst hemorrhage are frequent and serious complications of autosomal dominant polycystic kidney disease (ADPKD), often being difficult to diagnose and treat. The first objective of this study is to clarify the clinical features of ADPKDpatients with cyst hemorrhage or infection. The second objective is to establish diagnostic criteria for ADPKDpatients with cyst infection or cyst hemorrhage. PATIENTS AND METHODS: Patients with definite cyst infection or hemorrhage were enrolled from among the ADPKDpatients referred to us between January 2004 and October 2011. We investigated their symptoms, laboratory data, and the computed tomography (CT)/magnetic resonance imaging (MRI) features of infected cysts (before and after onset), normal cysts, and cysts with hemorrhage. RESULTS: There were 24 patients with cyst infection (36 infected cysts) and 12 patients with acute cyst hemorrhage (13 bleeding cysts). White blood cell (WBC) count >10,000/μl, serum C-reactive protein (CRP) >15.0 mg/dl, and body temperature >38 °C strongly suggested cyst infection. All of the cysts with hemorrhage contained a high-density mass-like area or showed overall high density on CT, and all patients with cyst hemorrhage had abdominal pain or gross hematuria. On the other hand, infected cysts showed an increase of intensity on MRI [diffusion-weighted imaging (DWI)], while a fluid-fluid level, wall thickening, and gas were also evidence of infection. Abdominal pain and/or sequential changes on MRI after onset of symptoms were useful for localizing infected cysts. CONCLUSION:Acute cyst hemorrhage and infection can be identified from symptoms, laboratory data, and CT/MRI findings.
Authors: Alex Ryan; Barry McCook; Beatta Sholosh; Daniel A Pryma; Eric Jablonowski; Carl Fuhrman; Todd M Blodgett Journal: Clin Nucl Med Date: 2007-09 Impact factor: 7.794
Authors: Eric Laffon; Anne-Laure Cazeau; Antoine Monet; Henri de Clermont; Philippe Fernandez; Roger Marthan; Dominique Ducassou Journal: J Nucl Med Technol Date: 2008-11-13
Authors: Arlene B Chapman; Olivier Devuyst; Kai-Uwe Eckardt; Ron T Gansevoort; Tess Harris; Shigeo Horie; Bertram L Kasiske; Dwight Odland; York Pei; Ronald D Perrone; Yves Pirson; Robert W Schrier; Roser Torra; Vicente E Torres; Terry Watnick; David C Wheeler Journal: Kidney Int Date: 2015-03-18 Impact factor: 10.612
Authors: T Suwabe; H Araoka; Y Ubara; K Kikuchi; R Hazue; K Mise; S Hamanoue; T Ueno; K Sumida; N Hayami; J Hoshino; A Imafuku; M Kawada; R Hiramatsu; E Hasegawa; N Sawa; K Takaichi Journal: Eur J Clin Microbiol Infect Dis Date: 2015-04-08 Impact factor: 3.267
Authors: William J Brock; James J Beaudoin; Jason R Slizgi; Mingming Su; Wei Jia; Sharin E Roth; Kim L R Brouwer Journal: Int J Toxicol Date: 2018 Mar/Apr Impact factor: 2.032
Authors: Marie Neuville; Roland Hustinx; Jessica Jacques; Jean-Marie Krzesinski; François Jouret Journal: PLoS One Date: 2016-08-16 Impact factor: 3.240