18F-FDG PET/CT demonstrated renal and hepatic cyst infection in a patient with autosomal dominant polycystic kidney disease

Abstract

Infection of renal or hepatic cyst is a serious complication of autosomal dominant polycystic kidney disease (ADPKD) and early diagnosis is crucial for the correct management. We report a case of 64-year-old male with ADPKD, who required renal transplantation some years before, with recent recurrent episodes of fever and abdominal pain, who underwent 18 F-FDG PET/CT twice at 18 months intervals, after not conclusive conventional imaging studies (CT, ultrasonography).18 F-FDG PET/CT has proven to be a useful method for the diagnosis of renal and hepatic cyst infection in a patient with ADPKD and for the subsequent management.

Clinical problems in hemodialysis patients with autosomal dominant polycystic kidney disease

“…Since discrimination between renal and liver cyst infections is not possible using clinical findings, fluorodeoxyglucose positron emission tomography (FDG-PET) can assist in establishing the diagnosis by localizing the infection 60,62,65. In addition, in ADPKD patients with acute abdominal pain and fever, FDG-PET also helps in the diagnosis of both liver and renal cyst infections; radiological imaging with FDG-PET is better than that with CT or MRI 66,67. Cyst infections can be life threatening and have a tendency to recur.Lipid-soluble antibiotics like fluoroquinolones show good penetration into cysts and are recommended for the treatment of cyst infections for at least 6 weeks 60.…”

The Impact of Glycolysis and Its Inhibitors on the Immune Response to Inflammation and Autoimmunity

“…Moreover, an evaluation of metastatic infection of high-risk patients with bacteremia [ 50 ] and primary evaluation of vasculitides [ 51 ] could be performed. Other well-described applications, but without sufficient evidence-based indications, include the following: evaluation of potentially infected liver and kidney cysts in polycystic disease [ 52 ], suspected infection of intravascular devices [ 53 ], AIDS-associated opportunistic infections and associated tumors [ 54 ], and assessment of metabolic activity in tuberculosis lesions [ 55 ]. Recent data also indicate other indications for FDG-PET imaging, like rheumatologic diseases (rheumatoid arthritis, rheumatic polymyalgia, and lupus erythematosus) [ 56 ], osteoporosis [ 57 ], spondylodiscitis [ 58 ], and idiopathic retroperitoneal fibrosis (RPF) [ 59 ].…”