Aortic, hepatic and renal artery aneurysms in autosomal dominant polycystic kidney disease
[To cite: Kumar D, Mishra H, Prasad U. Aortic, hepatic and renal artery aneurysms in autosomal dominant polycystic kidney disease. Natl Med J India 2022;35:372–3.]
A 55-year-old woman, known case of autosomal dominant polycystic kidney disease (ADPKD), presented with generalized weakness, episodic haematuria and occasional dyspnoea for a few days. On echocardiography, aneurysm of the arch of aorta was suspected. She had a CT angiography of the thorax and abdomen vessels, which showed features of ADPKD with bilateral enlarged kidneys and multiple cysts in the kidney and liver parenchyma (Fig. 1). CT angiography showed aneurysm of the arch of aorta (measuring 3.3 cm) (Fig. 2) and two small aneurysms in the left hepatic artery (measuring 9×9 mm and 7×7 mm) and a small aneurysm in the intrarenal branch of the left renal artery (Figs 3 and 4). The right renal artery was seen to originate at the level of the superior mesenteric artery (Fig. 5).
ADPKD is a major cause for end-stage renal disease and the presenting complaints are vague abdominal discomfort, haematuria, hypertension and urinary tract infection.1 Radiologically, numerous cysts are seen in the kidneys, liver, pancreas, spleen and seminal vesicle. Extra-renal manifestations of the disease include central nervous cysts, cardiac complications (mitral valve prolapse), diverticular disease, decreased fertility in men and aneurysmal malformation of the blood vessels.2,3 Intracranial aneurysms occur in about 6% to 20% of ADPKD patients and have a higher risk of subarachnoid haemorrhage. Aneurysms are also seen in the aorta, popliteal, splenic and coronary arteries.3 We have not been able to find published data regarding hepatic and renal artery aneurysms in ADPKD patients.
Conflict of interest
- Harrison’s Principles of Internal Medicine. Vol Vol II. New York: McGraw Hill; 2015. p. :1850.
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