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Unusual sonographic features of ARPKD
Authors:Maria Okumura  Victor Bunduki  Christina Shiang  Regina Schultz  Marcelo Zugaib
Institution:1. Department of Obstetrics, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil;2. Division of Pathology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
Abstract:The classic sonographic appearance of the kidneys in fetuses with autosomal recessive polycystic kidney disease (ARPKD) has been well described. We report a case of enlarged kidneys with pyramidal hyperechogenicity quite similar to medullary nephrocalcinosis found in a fetus at 34 weeks' gestation. At 39 weeks, a female neonate was delivered and died after 22 h due to pulmonary insufficiency secondary to severe oligohydramnios. On pathological analysis, the gross and microscopic findings were typical of ARPKD with diffuse dilatation of tubules throughout. The fetal renal lobulation was prominent and on section, the pyramids were delineated within each lobule, accounting for the clear image of the pyramids observed on sonography. Copyright © 2006 John Wiley & Sons, Ltd.
Keywords:autosomal recessive polycystic kidney  prenatal diagnosis  sonography  medullary nephrocalcinosis
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