Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review

Abstract Background In patients with autosomal dominant polycystic kidney disease (ADPKD), renal and hepatic cystic infections are common complications, sometimes frequent and refractory. Hemorrhagic complications are often present in these cases. Owing to the diversity of patient backgrounds, the t...

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Main Authors: Shunsuke Takayanagi, Keita P. Mori, Shigeto Kubo, Natsumi Mishima, Tomoka Watanabe, Mea Asou, Misaki Taniguchi, Miho Miyauchi, Yoshiaki Higashi, Takaya Handa, Tomomi Endo, Takeshi Matsubara, Tatsuo Tsukamoto
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Renal Replacement Therapy
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Online Access:https://doi.org/10.1186/s41100-024-00591-7
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author Shunsuke Takayanagi
Keita P. Mori
Shigeto Kubo
Natsumi Mishima
Tomoka Watanabe
Mea Asou
Misaki Taniguchi
Miho Miyauchi
Yoshiaki Higashi
Takaya Handa
Tomomi Endo
Takeshi Matsubara
Tatsuo Tsukamoto
author_facet Shunsuke Takayanagi
Keita P. Mori
Shigeto Kubo
Natsumi Mishima
Tomoka Watanabe
Mea Asou
Misaki Taniguchi
Miho Miyauchi
Yoshiaki Higashi
Takaya Handa
Tomomi Endo
Takeshi Matsubara
Tatsuo Tsukamoto
author_sort Shunsuke Takayanagi
collection DOAJ
description Abstract Background In patients with autosomal dominant polycystic kidney disease (ADPKD), renal and hepatic cystic infections are common complications, sometimes frequent and refractory. Hemorrhagic complications are often present in these cases. Owing to the diversity of patient backgrounds, the treatment of these complications has not been standardized. Here we report three cases that suggest the significance of detecting and treating hemorrhagic complications in cases of cyst infection. Case presentation Case 1: A 46-year-old man on low-dose aspirin for antiphospholipid antibody syndrome presented with fever, left flank pain, and gross hematuria. He had a history of frequent renal cyst infections. Imaging studies revealed a hemorrhagic cyst infection of the left kidney and acute kidney injury. He was treated with ciprofloxacin and tranexamic acid, and aspirin was discontinued. Subsequently, infection and bleeding successfully improved after treatment for 2 months. To date, cyst infection has not recurred. Case 2: A 70-year-old man on eicosapentaenoic acid for dyslipidemia presented with fever and left flank pain which was diagnosed as a hemorrhagic cyst infection of the left kidney. He had a history of renal cyst infection. Hemorrhagic cyst infection of the left kidney was made with imaging studies and positive blood cultures. Ciprofloxacin and metronidazole were administered, and eicosapentaenoic acid was discontinued. The infection and bleeding resolved after treatment for 1 month. To date, cyst infection has not recurred. Case 3: A 63-year-old man on chronic maintenance hemodialysis receiving warfarin for atrial fibrillation and cardiogenic cerebral embolism presented with fever, back pain, and hypotension. On magnetic resonance imaging (MRI) and computerized tomography (CT), he was diagnosed with hemorrhagic cyst infection of the liver. Despite multidrug antibiotic therapy and discontinuation of warfarin, the bleeding tendency did not improve, and he died after 3 months. Conclusions Since cyst hemorrhage might be an aggravating complication in the treatment of refractory and recurrent cyst infections in patients with ADPKD, we believe that a careful imaging evaluation should be performed to detect cyst hemorrhage in these cases.
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spelling doaj-art-ca75a2288a57420e8839b7ee58e17a3d2024-12-08T12:46:30ZengBMCRenal Replacement Therapy2059-13812024-12-0110111510.1186/s41100-024-00591-7Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature reviewShunsuke Takayanagi0Keita P. Mori1Shigeto Kubo2Natsumi Mishima3Tomoka Watanabe4Mea Asou5Misaki Taniguchi6Miho Miyauchi7Yoshiaki Higashi8Takaya Handa9Tomomi Endo10Takeshi Matsubara11Tatsuo Tsukamoto12Department of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Radiology, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiDepartment of Nephrology and Dialysis, Medical Research Institute KITANO HOSPITAL, PIIF Tazuke-KofukaiAbstract Background In patients with autosomal dominant polycystic kidney disease (ADPKD), renal and hepatic cystic infections are common complications, sometimes frequent and refractory. Hemorrhagic complications are often present in these cases. Owing to the diversity of patient backgrounds, the treatment of these complications has not been standardized. Here we report three cases that suggest the significance of detecting and treating hemorrhagic complications in cases of cyst infection. Case presentation Case 1: A 46-year-old man on low-dose aspirin for antiphospholipid antibody syndrome presented with fever, left flank pain, and gross hematuria. He had a history of frequent renal cyst infections. Imaging studies revealed a hemorrhagic cyst infection of the left kidney and acute kidney injury. He was treated with ciprofloxacin and tranexamic acid, and aspirin was discontinued. Subsequently, infection and bleeding successfully improved after treatment for 2 months. To date, cyst infection has not recurred. Case 2: A 70-year-old man on eicosapentaenoic acid for dyslipidemia presented with fever and left flank pain which was diagnosed as a hemorrhagic cyst infection of the left kidney. He had a history of renal cyst infection. Hemorrhagic cyst infection of the left kidney was made with imaging studies and positive blood cultures. Ciprofloxacin and metronidazole were administered, and eicosapentaenoic acid was discontinued. The infection and bleeding resolved after treatment for 1 month. To date, cyst infection has not recurred. Case 3: A 63-year-old man on chronic maintenance hemodialysis receiving warfarin for atrial fibrillation and cardiogenic cerebral embolism presented with fever, back pain, and hypotension. On magnetic resonance imaging (MRI) and computerized tomography (CT), he was diagnosed with hemorrhagic cyst infection of the liver. Despite multidrug antibiotic therapy and discontinuation of warfarin, the bleeding tendency did not improve, and he died after 3 months. Conclusions Since cyst hemorrhage might be an aggravating complication in the treatment of refractory and recurrent cyst infections in patients with ADPKD, we believe that a careful imaging evaluation should be performed to detect cyst hemorrhage in these cases.https://doi.org/10.1186/s41100-024-00591-7Autosomal dominant polycystic kidney diseaseADKPDCyst infectionCyst hemorrhageChronic kidney disease
spellingShingle Shunsuke Takayanagi
Keita P. Mori
Shigeto Kubo
Natsumi Mishima
Tomoka Watanabe
Mea Asou
Misaki Taniguchi
Miho Miyauchi
Yoshiaki Higashi
Takaya Handa
Tomomi Endo
Takeshi Matsubara
Tatsuo Tsukamoto
Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
Renal Replacement Therapy
Autosomal dominant polycystic kidney disease
ADKPD
Cyst infection
Cyst hemorrhage
Chronic kidney disease
title Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
title_full Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
title_fullStr Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
title_full_unstemmed Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
title_short Significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease: a case presentation with literature review
title_sort significance of bleeding control in hemorrhagic cyst infection in autosomal dominant polycystic kidney disease a case presentation with literature review
topic Autosomal dominant polycystic kidney disease
ADKPD
Cyst infection
Cyst hemorrhage
Chronic kidney disease
url https://doi.org/10.1186/s41100-024-00591-7
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