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ORIGINAL CONTRIBUTION |
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| Year : 1997 | Volume
: 51
| Issue : 4 | Page : 118-119 |
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Hepatic cysts in adult polycystic kidney disease
Siva V Kumar, Kishore S Babu, R Agarwal, Siddartha B Kumar, AY Lakshmi, CK Reddy
Department of Nephology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthi Gram, Beedupalli Post, India
Correspondence Address:
Siva V Kumar
Department of Nephology, Sri Sathya Sai Institute of Higher Medical Sciences, Prasanthi Gram, Beedupalli Post
India
PMID: 9355697
How to cite this article:
Kumar SV, Babu KS, Agarwal R, Kumar SB, Lakshmi A Y, Reddy C K. Hepatic cysts in adult polycystic kidney disease. Indian J Med Sci 1997;51:118-9 |
Adult Potycystic Kidney Disease (APKD) is a multisystem disease with autosomal dominant genetic mediation. Hepatic involvement is one of the important extra-renal manifestation of APKD. The present study was designed to evaluate the Hepatic cystic involvement in relation to the clinical presentation of PolycysJc Kidneys.
| ¤ Material and Methods | |  |
Ninety two APKD patients were evaluated by clinical, biochemical, hematological and sonography examination. Patients with hepatic cystic involvement were studied with reference to age, sex, family history, extent of involvement, relation to renal failure and presentation.
| ¤ Results | | |
Ninety two Adult Polycystic Kidney Disease Patients were evaluated for hepatic cystic involvement of them 17 (18.5%) were found to have hepatic cysts. Of these 17, twelve (70.6% ) ) were men five (29.4%) were women. 16 had a negative family history for PKD. Mean age in females was 48 yrs and in males 51 yrs. Renal failure was noted in 58.8% of patients with hepatic cystic disease. Jaundice was not seen in any one. Vague abdominal pain and mass in abdomen was the presenting symptom in 8 patients (47%).
On an average APKD accounts for approximately 1 in 3000 hospital admissions and 1 in 500 autopsies. [1] Extrarenal cysts occur in liver in 20 . 50% of Polycystic kidney disease [2],[3] and conversely Polycys_ic kidneys are found in 20-58% of individuals with polycystic livers. [4] The incidence of hepatic cysts in APKD is reported to be more in the female sex, in the elderly and in those with severe renal disease. [4],[5],[6] Liver cysts are usually asymptomatic but occasionally result in obstructive jaundice and portal hypertension. Regarding hepatic cystogenesis genetic, hormonal, and circulating cystogenic substances in renal failure are supposed to be responsible. [4],[6] The pathophysiology of liver cysts is not well understood. They are thought to originate from Von Meyenburg's complexes (also called biliary micro hemartomas) which are thought to arise from intrahepatic bile ducts which fail to involute. These complexes were found in almost all cases, of cystic liver in adult PKD. [2],[3]
In our study 18.5% of PKD patients had hepatic cysts. Hepatic cysts were more common in men (70.6%) . 58.8% of patients with hepatic cystic disease had renal failure. 47% of the patients with hepatic cysts had abdominal mass and vague pain abdomen as the presenting feature. None had jaundice or portal hypertension. Women presented with hepatic cysts at a lower age (48 yrs) in comparison to men (51 yrs). All the patients of hepatic cystic involvement had negative family history for APKD except one.
| ¤ Summary | | |
Of ninety two adult polycystic kidney patients 18.5% had liver cysts. Mostly they were multiple. Liver cysts were more common in men.[7]
| ¤ References | | |
| 1. | Suki WN. Polycystic kidney disease. Kidney International 1982: 22:571-80.  |
| 2. | Welling LW. Grantham JJ. Cysts and developmental diseases of the kidney. In : Brenner BN, Rector FC. Ed. The Kidney W.B. Saunders company, Philadelphia, 1991:pp 1657-1694. |
| 3. | Zeier M, Gebrerth S, Ritz E, Jaeger T, Waldherr R. Adult domi nant polycystic kidney disease - clinical problems. Nephron 1988: 49:177-83. |
| 4. | Gabow PA, Grantham JJ. Polycystic kidney disetse. In:Schrier RW, Gottschalk CW, Ed. Diseases of the kidney. Little, Brown and company, Boston, 1993; pp 535-564. |
| 5. | Glassberg K. Autosomal dominant polycystic kidney disease. In: Walsh, Retik, Stamey, Baughan, Ed. Campbell's Text Book of Urology. W.B. Saunders company, Philadelphia 1992; pp 1443-1495. |
| 6. | Godela MF, Gabow PA. Hereditary and acquired cystic diseases of the Kidney International 1994;46: 1951-64. |
| 7. | Pirson Y, Grunfield JP. Autosomal dominant polycystic kidney disease. In: Cameron S, Davison AM, Grunfield JP, Kerr D, Ritz E, Ed. Oxford Text Book of clinical Nephology. Oxford:1992:pp 2171-2188. |
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| Rosenfeld L, Bonny C, Kallita M, et al. | | GASTROENTEROLOGIE CLINIQUE ET BIOLOGIQUE. 2002; 26 (12): 1097-1106 | | [Pubmed] | |
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