A case of pulmonary embolism caused by compression of the vena cava by intra‐abdominal masses in autosomal polycystic kidney disease

Abstract

Approximately 10% of dialysis patients suffer from autosomal dominant polycystic kidney disease. This disorder leads to several complications including infections, hematuria, and chronic pain. Here, we present a case of a 48-year-old patient with pulmonary artery embolism due to vena cava obstruction by the right polycystic kidney. Although not very common in the general population, autosomal dominant polycystic kidney disease is one of the more common autosomal dominant inherited diseases. The prevalence in dialysis patients is approximately 10% and approximately 1/1000-1/400 live births. 1,2 The underlying mutation is found in the polycystic kidney disease 1 (PKD1) gene in 85% of all cases and in the PKD2 gene in 15% of all cases. 2 Common complications are cyst infections, hematuria, cyst bleeding, nephrolithiasis, and chronic pain. 3 Cerebral aneurysms may cause intracranial bleeding, yet the risk for aneurysm ruptures is usually regarded low. 3 Other organs, particularly the liver, but also blood vessels and the heart can be affected. 3 The increasing kidney volume (due to growing cyst volume) may lead to a compression of intra-abdominal structures; however, a pulmonary embolism caused by this complication has rarely been reported.

Pulmonary Embolism in Autosomal Dominant Polycystic Kidney Patient Induced by Inferior Vena Cava Mechanical Compression

“…Morimoto and colleagues also showed that tolvaptan, which prevents renal cyst development, could cause acute pulmonary thromboembolism during treatment for autosomal dominant polycystic kidney disease [7] . A few other cases discussed the same mechanism of pulmonary embolism due to a large cyst that compressed the inferior vena cava [8][9][10][11][12][13] .…”