77 Autosomal Dominant Polycystic Kidney Disease

Clinical Presentation

A 6-year-old boy underwent abdominal ultrasonography because of a recent urinary tract infection (UTI). A positive family history of renal disease was present.

Figure 77A

Radiologic Findings

A longitudinal ultrasound image of the right kidney shows two anechoic lesions, both approximately 1.5 cm in diameter, with some posterior acoustic enhancement typical of renal cysts (Fig. 77A), which corresponded to the family history. The remaining right kidney and the left kidney were normal.

Diagnosis

Autosomal dominant polycystic kidney disease (ADPKD)

Differential Diagnosis

Multiple simple renal cysts (An occasional simple renal cyst may be seen in childhood, but multiple cysts do not normally occur, and the positive family history mentioned above is conclusive.)
Caliceal diverticula (Multiple diverticula would be very rare-one caliceal diverticulum may be indistinguishable from a simple renal cyst, but on IVU a caliceal diverticulum should opacify with contrast.)
Multicystic dysplastic kidney (is a congenital unilateral disorder, usually without normal parenchyma on the affected side)
Autosomal recessive polycystic kidney disease (manifests on ultrasound with bilateral large echogenic kidneys generally without resolvable cysts)
Tuberous sclerosis (TS)