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BMJ Case Reports 2018; doi:10.1136/bcr-2017-220118
  • Findings that shed new light on the possible pathogenesis of a disease or an adverse effect
  • CASE REPORT

Liver Failure in Advanced Adult-onset Polycystic Kidney Disease

  1. Grant Gardner Gallimore2
  1. 1Internal Medicine, Keesler Medical Center, Biloxi, Mississippi, USA
  2. 2Internal Medicine, Keesler Medical Center, Biloxi, Mississippi, USA
  1. Correspondence to Dr. Christina Awad, cnawad18{at}gmail.com
  • Accepted 28 March 2018
  • Published 13 April 2018

Summary

Polycystic liver disease is the most common extrarenal manifestation of autosomal dominant polycystic kidney disease (ADPKD). Hepatic cysts are typically incidental findings, with occasional complications including cyst haemorrhage, infection and rupture. In contrast to the typically benign course of polycystic liver disease, we present a rare case of fatal decompensated liver failure in a patient with ADPKD. This is a case of a 58-year-old man with end-stage renal disease on haemodialysis presenting with new-onset ascites and decompensated liver failure following bilateral nephrectomy. Cirrhosis in ADPKD is a late manifestation of the disease, but it should be considered in the perioperative risk of patients with ADPKD.

Footnotes

  • Contributors CA was a part of the team treating this discussed patient. She performed the necessary literature review, patient consent, the primary data collection and write-up of the case. GGG is the expert on the topic. He performed the literature review as well and provided the appropriate articles/references for the case and helped CA understand the topic. He proof-read and edited all CA’s drafts, and assisted in drafting the discussion and the conclusion for this case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Next of kin consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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