• Aucun résultat trouvé

Diagnostic Management of Suspected Acute Cyst Complication in Patients with Autosomal Dominant Polycystic Kidney Disease

N/A
N/A
Protected

Academic year: 2021

Partager "Diagnostic Management of Suspected Acute Cyst Complication in Patients with Autosomal Dominant Polycystic Kidney Disease"

Copied!
1
0
0

Texte intégral

(1)

• Retrospective identification of ADPKD patients presenting with abdominal pain and/or fever between January 2005 and June 2015 in a prospective computerized database

• Stepwise and systematic review of all medical files • Diagnostic criteria:

 CyH: intracystic density above 50 Hounsfield units on CT  CyI:

~ “definite” by cyst fluid analysis showing bacteria or neutrophils

~ “probable” in case of concomitant presence of: 1. temperature >38°C for 3 days

2. loin or liver tenderness

3. CRP plasma level >50 mg/L 4. no CT evidence for CyH

 FUO: episodes out of criteria for CyH or CyI

Diagnostic yields of conventional imaging techniques in CyI were:

Ultrasounds: 2.6% (1/38)

Computed tomography: 20.6% (7/34)

Magnetic resonance imaging: 16.7% (1/6)

p<0.05 p<0.001 p<0.05 p<0.05

Diagnostic Management of Suspected Acute Cyst Complication

in Patients with Autosomal Dominant Polycystic Kidney Disease

Marie Neuville

1

, Roland Hustinx

2

, Jean-Marie Krzesinski

1

and François Jouret

1

Divisions of (1) Nephrology and (2) Nuclear Medicine, University of Liège Hospital (ULg CHU), Liège, Belgium

• Two main types of acute cyst complication in patients with autosomal dominant polycystic kidney disease (ADPKD):  cyst infection (CyI)

 cyst hemorrhage (CyH)

• Double diagnostic challenge :

 differentiating acute cystic from non-cystic diseases  distinguishing CyI from CyH

• Prominence of an accurate diagnosis to target the treatment:  CyI: 6-week antibiotic therapy (and cyst puncture)

 CyH: antalgics and watchful waiting

• Recent suggestion of diagnostic criteria, with unknown sensibility and specificity

This monocentric 10-year retrospective study aims at challenging clinical, biological and imaging criteria in order to propose a diagnostic algorithm in the management of suspected acute cyst complication

Background and Objectives

Background and Objectives

Demographics of the Cohort

Demographics of the Cohort

Bacteriological Documentation

Bacteriological Documentation

Diagnostic Algorithm

Diagnostic Algorithm

Discussion

Discussion

This monocentric 10-year retrospective study including 88 episodes of suspected acute cyst complication in 53 ADPKD patients highlights:

the usefulness of clinical, i.e. fever, and biological, i.e. CRP levels, criteria to distinguish CyI from CyH;the limitations of bacteriological and conventional radiological investigations;

Références

Documents relatifs

Toutes les salles sont équipées des technologies les plus récentes avec, pour les deux plus grandes, l’image en 3D et, surtout, dans la salle N°1, le nouveau son 3D Dolby Atmos

Cela rend également visible ce qui, pour des raisons de sécurité, se déroulera dans des halles fermées – de l’excavation des déchets par un système à ponts

(collective noun + singular or plural verb; audience can also be used as a countable noun with a normal plural: audiences are; also: class, club, committee, company,

Nous$ avons$ pour$ l'instant$ évoqué$ uniquement$ l'huile$ de$ palme$ contenue$ dans$ les$

[r]

The aim of the present study was to test the unique value of Siegrist’s effort–reward-imbalance model (Sie- grist et al. 1997 ) in predicting vital exhaustion indepen- dently of

Neptunium sorption and redox speciation at the illite surface under highly saline conditions.. Nidhu Lal Banik, Rémi Marsac, Johannes Lützenkirchen, Christian Maquardt, Kathy

In this study, the shell-shaped model was fit to the g-value data to determine CME speeds in the solar wind, and the radial variation of propagation speeds between the corona and