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CASE REPORT
Year : 2019  |  Volume : 5  |  Issue : 4  |  Page : 79-82

A missed cause of abdominal pain and malnutrition in autosomal dominant polycystic kidney disease


1 Department of Nephrology and Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India
2 Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India

Correspondence Address:
Dr. Smita Divyaveer
Department of Nephrology, Post Graduate Institute of Medical Education and Research, Sector 12. Chandigarh - 160 012
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrnm.jrnm_4_20

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A 62-year-old lady having autosomal dominant polycystic kidney disease (ADPKD) with gradual progression of chronic kidney disease (CKD) to end-stage renal disease presented with anorexia and dull-aching continuous abdominal discomfort. She had no response to conservative management and was started on maintenance hemodialysis. She followed up 3 months later. Her symptoms had only marginally improved initially despite continuing dialysis, and she continued to be malnourished. She presented to the emergency department with worsening abdominal pain and obstipation. Contrast-enhanced computed tomography abdomen was done which showed signs of abdominal tuberculosis with bowel obstruction. She was taken up for surgery. On postoperative day 2, she had refractory septic shock and cardiac arrest and could not be revived. Dull-aching chronic abdominal pain in ADPKD is common and is attributed to increased kidney sizes. With progression of CKD to uremia, anorexia is common. However, other causes of abdominal pain and malnutrition may be overlooked. In our case, the patient had abdominal tuberculosis which was the cause of persistent anorexia and malnutrition. Close follow-up of nutritional status and evaluation of malnutrition in patients with CKD is of paramount importance.


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