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AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE WITH CYSTIC HAEMORRHAGE AND INFECTION

A 49-year-old man with adult polycystic kidney disease and chronic renal failure receiving regular haemodialysis for 8 months presented with a 2 week history of abdomen pain, gross haematuria and intermittent fever. His vital signs: blood pressure 140/84 mmHg, body temperature 38.8 °C. Physical examination demonstrated ovoid of the abdomen, diminished bowel sound and epigastric tenderness without rebounding pain. Laboratory studies showed haemoglobin 11.8 g/dl, WBC 15400/ul, blood urea nitrogen 52 mg/dL, creatinine 8.7 mg/dL and C-reactive protein 48 mg/dl. In order to rule out intra-abdominal infection, CT scans of the abdomen revealed enlargement of both kidney with thin renal parenchyma and numerous cystic lesions (Figure 1). Clinical diagnosis of adult polycystic kidney disease with cystic haemorrhage and infection was made. After exploratory laparotomy with bilateral nephrectomy, the patient’s symptoms improved progressively (Figure 2). The patient was fi nally discharged in a stable condition.