scholarly journals A tale of an unfortunate outcome in COVID-era

2020 ◽  
pp. 115-119
Author(s):  
Talha Sami Ul Haque ◽  
Ishrat Jahan ◽  
Muhammad Abdur Rahim ◽  
Tufayel Ahmed Chowdhury ◽  
Mehruba Alam Ananna ◽  
...  
Keyword(s):  
Thrombus Formation ◽  
Renal Stones ◽  
Aortic Aneurysms ◽  
Polycystic Kidney ◽  
Intraluminal Thrombus ◽  
Diabetic Hypertensive Patient ◽  
Liver And Pancreas ◽  
History Of ◽  
Autosomal Dominant Polycystic Kidney ◽  
Arterial Aneurysms

Autosomal dominant polycystic kidney disease (ADPKD) primarily affects the kidneys; cysts can develop in other organs like liver and pancreas and sometimes complicated with formation of arterial aneurysms, brain being the commonest site. Aortic aneurysms can lead to thromboembolic events. Thromboembolism is also a recognized complication of coronavirus disease 2019 (COVID-19). Here, we present case history of an elderly diabetic, hypertensive patient with bilateral renal stones, who presented with gangrene of the left 5th toe and raised serum creatinine. He was later diagnosed as a case of COVID-19, ADPKD with aortic aneurysm, which was complicated with intraluminal thrombus formation and unfortunately, he died in course of treatment. Birdem Med J 2020; 10, COVID Supplement: 115-119

Effects of long-term chloroquine administration on the natural history of aortic aneurysms in mice

2015 ◽  
Vol 93 (8) ◽  
pp. 641-648 ◽  
Author(s):  
Azza Ramadan ◽  
Mark D. Wheatcroft ◽  
Adrian Quan ◽  
Krishna K. Singh ◽  
Fina Lovren ◽  
...  
Keyword(s):  
Natural History ◽  
Thrombus Formation ◽  
Aortic Aneurysms ◽  
Ang Ii ◽  
Abdominal Aortic ◽  
Suprarenal Aorta ◽  
History Of ◽  
Categorical Distribution

Autophagy regulates cellular homeostasis and integrates the cellular pro-survival machinery. We investigated the role of autophagy in the natural history of murine abdominal aortic aneurysms (AAA). ApoE−/− mice were implanted with saline- or angiotensin II (Ang-II)-filled miniosmotic pumps then treated with either the autophagy inhibitor chloroquine (CQ; 50 mg·(kg body mass)–1·day–1, by intraperitoneal injection) or saline. Ang-II-elicited aneurysmal expansion of the suprarenal aorta coupled with thrombus formation were apparent 8 weeks later. CQ had no impact on the incidence (50% for Ang-II compared with 46.2% for Ang-II + CQ; P = NS) and categorical distribution of aneurysms. The markedly reduced survival rate observed with Ang-II (57.1% for Ang-II compared with 100% for saline; P < 0.05) was unaffected by CQ (61.5% for Ang-II + CQ; P = NS compared with Ang-II). CQ did not affect the mean maximum suprarenal aortic diameter (1.91 ± 0.19 mm for Ang-II compared with 1.97 ± 0.21 mm for Ang-II + CQ; P = NS). Elastin fragmentation, collagen accumulation, and smooth muscle attrition, which were higher in Ang-II-treated mice, were unaffected by CQ treatment. Long-term CQ administration does not affect the natural history and prognosis of experimental AAA, suggesting that global loss of autophagy is unlikely to be a causal factor in the development of aortic aneurysms. Manipulation of autophagy as a mechanism to reduce AAA may need re-evaluation.

scholarly journals An 11-Year-Old Child with Autosomal Dominant Polycystic Kidney Disease Who Presented with Nephrolithiasis

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Fatih Firinci ◽  
Alper Soylu ◽  
Belde Kasap Demir ◽  
Mehmet Turkmen ◽  
Salih Kavukcu
Keyword(s):  
Kidney Disease ◽  
General Population ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Renal Stones ◽  
Age Group ◽  
Metabolic Abnormalities ◽  
Polycystic Kidney ◽  
Autosomal Dominant Polycystic Kidney

Patients with autosomal dominant polycystic kidney disease become symptomatic and are diagnosed usually at adulthood. The rate of nephrolithiasis in these patients is 5–10 times the rate in the general population, and both anatomic and metabolic abnormalities play role in the formation of renal stones. However, nephrolithiasis is rare in childhood age group. In this paper, an 11-year-old child with autosomal dominant polycystic kidney disease presenting with nephrolithiasis is discussed.

A Relation Between Particle Hemodynamics and Intraluminal Thrombus Formation in Abdominal Aortic Aneurysms

2009 ◽  
Author(s):  
Christopher A. Basciano ◽  
Julie H. Y. Ng ◽  
Ender A. Finol ◽  
Clement Kleinstreuer
Keyword(s):  
Particle Deposition ◽  
Thrombus Formation ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Blood Proteins ◽  
Intraluminal Thrombus ◽  
Abdominal Aortic ◽  
Cellular Debris ◽  
The Us ◽  
Normal Diameter

Abdominal aortic aneurysms (AAAs) are local dilations of the aorta below the renal arteries where the lumen diameter is ≥ 1.5 times the normal diameter of the healthy blood vessel. Ruptured aneurysms are the 13th leading cause of death in the US [1]. In approximately 75% of all AAAs, a particle-deposition layer forms adjacent to the arterial wall within the lumen called the intra-luminal thrombus (ILT). The thrombus composition has been shown to be a fibrin structure composed of blood cells, platelets, blood proteins, and other cellular debris [2]. Additionally, Yamazumi et al. [3] have presented data that suggest AAA morphology is associated with an elevated state of blood coagulation and fibrinolysis within the aneurysm.

Natural history of intracranial aneurysms in autosomal dominant polycystic kidney disease

2017 ◽  
Vol 51 (6) ◽  
pp. 476-480 ◽  
Author(s):  
Mariusz Niemczyk ◽  
Monika Gradzik ◽  
Magda Fliszkiewicz ◽  
Andrzej Kulesza ◽  
Marek Gołębiowski ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Natural History ◽  
Polycystic Kidney Disease ◽  
Intracranial Aneurysms ◽  
Autosomal Dominant ◽  
Polycystic Kidney ◽  
History Of ◽  
Autosomal Dominant Polycystic Kidney

scholarly journals Nephrectomy in patients with autosomal dominant polycystic kidney disease after kidney transplantation

2020 ◽  
Vol 13 (5) ◽  
pp. 126-131
Author(s):  
A.E. Lubennikov ◽  
◽  
R.N. Trushkin ◽  
D.F. Kantimerov ◽  
L.Yu. Artyukhina ◽  
...  
Keyword(s):  
Kidney Transplantation ◽  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Imaging Method ◽  
Polycystic Kidney ◽  
Number Of Patients ◽  
History Of ◽  
Autosomal Dominant Polycystic Kidney ◽  
Inflammatory Changes

Introduction. In recent years, the number of patients with autosomal dominant polycystic kidney disease (ADPKD) who undergo kidney transplantation without nephrectomy has increased. The most frequent and adverse complication from your own kidneys is infection of cysts (IC). This dictates the need to predict the probability of IC and determine diagnostic and therapeutic approaches in this category of patients. Materials and methods. The results of observation and treatment of 55 patients with ADPKD who underwent kidney transplantation from 2000 to 2019 without prior nephrectomy were evaluated. Results. Bilateral nephrectomy in connection with IC was performed in 10 (18.1%) patients, and one patient died from sepsis progression. Burdened urological history (kidney operations for suppuration of cysts and recurrent urinary tract infection (UTI)) significantly increased the chances of nephrectomy for IC by 6.8 times (AOR 6.83; 95% CI 1.34-34.8; p=0.021). The median time from kidney transplantation to nephrectomy was 7 months (Q1-Q3: 2-8). Acute graf pyelonephritis was associated with IR (p=0.045) in single-factor analysis. Forty-five patients are under observation, with a median follow-up of 41 months (Q1-Q3: 19-76). Seventeen patients underwent magnetic resonance imaging using diffusely weighted image protocols (MRI-DWI). MR-signs of infection were detected in 5 patients. Given the absence of clinical and laboratory manifestations of inflammation, nephrectomy was not performed. Further followup did not indicate the development of clinical and laboratory signs of UTI in any case. Discussion. As our study and a number of other studies have shown, in patients with ADPKD after kidney transplantation, the most frequent indication for nephrectomy is inflammatory changes in their own kidneys. Patients with a history of severe pyelonephritis or IC who previously had pyelonephritis or IC before kidney transplantation are at risk for developing inflammatory changes after kidney transplantation, and it does not matter how long ago they had a history of pyelonephritis attacks or kidney surgery. This fact should be taken into account before kidney transplantation and offer patients a nephrectomy before kidney transplantation. Our work is consistent with a number of non-numerous publications that have shown that in the diagnosis of IC, the most informative non-invasive, imaging method is MRI of the kidneys, but this method has low specificity, which can lead to an increase in the number of false positive conclusions and an increase in the number of unjustified nephrectomies. Conclusion. The predictor of infection of own kidney cysts after transplantation is a burdened urological history. MRI DWI has high sensitivity and low specificity in the diagnosis of IR in ADPKD. When identifying single cysts with MR-signs of infection in the absence of clinical, laboratory manifestations of UTI, nephrectomy is not indicated.

scholarly journals Abdominal aortic aneurysms and autosomal dominant polycystic kidney disease.

1996 ◽  
Vol 7 (11) ◽  
pp. 2483-2486
Author(s):  
R Torra ◽  
C Nicolau ◽  
C Badenas ◽  
C Brú ◽  
L Pérez ◽  
...  
Keyword(s):  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Abdominal Aortic Aneurysms ◽  
Aortic Aneurysms ◽  
Aortic Diameter ◽  
Polycystic Kidney ◽  
Abdominal Aortic ◽  
Healthy Family ◽  
Autosomal Dominant Polycystic Kidney

Although cases of autosomal dominant polycystic kidney disease (ADPKD) associated with abdominal aortic aneurysm have been repeatedly reported in the literature, no systematic studies of the aortas of these patients have been performed. In the study presented here, a sonographic study of the abdominal aorta in 139 ADPKD patients and in 149 healthy family members was carried out. For both groups, an increase in aortic diameter related to age and sex, (being wider in men than women) was found. In ADPKD patients, neither a wider aortic diameter nor a higher prevalence of abdominal aortic aneurysms could be found in any age group. It was concluded that, although these patients are prone to develop aortic aneurysms because of hypertension and associated connective tissue disorders, the presence of abdominal aortic aneurysms should be questioned as a frequent feature of ADPKD.

Management of intracranial aneurysms

2015 ◽  
Author(s):  
Yves Pirson ◽  
Dominique Chauveau
Keyword(s):  
Autosomal Dominant ◽  
Three Dimensional ◽  
Decision Analysis Model ◽  
Analysis Model ◽  
Patient Anxiety ◽  
Polycystic Kidney ◽  
Adequate Information ◽  
Treatment Of Hypertension ◽  
History Of ◽  
Autosomal Dominant Polycystic Kidney

An asymptomatic intracranial aneurysm (ICA) is found by screening in about 8% of patients with autosomal dominant polycystic kidney disease (ADPKD), with a trend to cluster in some families. Though most ICAs will remain asymptomatic, a minority of them may rupture, causing subarachnoid haemorrhage (SAH). Given the grave prognosis of ICA rupture, screening and prophylactic repair of unruptured ICAs have to be considered, with the aim to identify patients with a risk of ICA rupture that exceeds the risk of a prophylactic procedure, surgical or endovascular. Relying on a decision analysis model established in the general population, widespread screening in ADPKD patients is today not recommended. However, the chapter authors advise screening in ADPKD patients with a familial history of ICA or SAH. Additional acceptable indications are high-risk occupations and patient anxiety despite adequate information. Screening is preferably performed by high-resolution, three-dimensional, time-of-flight magnetic resonance imaging. When an asymptomatic ICA is found, a recommendation for whether to intervene depends on its size, site, morphology, patient life expectancy, and general health as well as the experience of the neuroradiologist–neurosurgeon team. Since the risk of new ICAs or enlargement of an existing one is very low in those with small (< 6 mm) ICAs, conservative management is usually recommended. Elimination of tobacco use and aggressive treatment of hypertension are strongly recommended.

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