title: Pleuritic chest pain from portal hypertensive gastropathy in ESRD patient with autosomal dominant polycystic kidney disease misdiagnosed as pericarditis.
abstract: Portal hypertensive gastropathy (PHG) is a gastric mucosal lesion complicating portal hypertension, with higher prevalence in decompensated cirrhosis. PHG can sometimes complicate autosomal dominant polycystic kidney disease (ADPKD) due to the presence of multiple liver cysts. Besides, PHG is known to present as chest pain, with or without hematemesis. Other causes of chest pain in ADPKD include referred chest pain from progressively enlarging kidney cysts, and rare pericardial cysts. Chest pain, especially if pleuritic, in end-stage renal disease (ESRD) patients, is often ascribed to uremic pericarditis. We present recurrent pleuritic chest pain in a 24-year old ESRD patient with ADPKD that was initially misdiagnosed as uremic pericarditis. It was ultimately shown to represent symptomatic PHG with excellent therapeutic response to proton pump inhibitors.
authors.affiliation: Mayo Clinic College of Medicine, Rochester, USA ; Department of Nephrology, Mayo Clinic Health System, Eau Claire, USA.
authors.forename: Macaulay Amechi Chukwukadibia
authors.initials: MA
authors.lastname: Onuigbo
authors.affiliation: North East London NHS Foundation Trust, UK.
authors.forename: Nneoma
authors.initials: N
authors.lastname: Agbasi
authors.affiliation: Aureus University School of Medicine, Oranjestad, Aruba.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Achebe
authors.affiliation: Department of Medicine, Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Charles
authors.initials: C
authors.lastname: Odenigbo
authors.affiliation: Department of Medicine, Nnamdi Azikiwe Teaching Hospital, Nnewi, Anambra State, Nigeria.
authors.forename: Fidelis
authors.initials: F
authors.lastname: Oguejiofor
keywords: ADPKD; Chest pain; End stage renal disease; Gastropathy; Pericarditis; Portal hypertensive gastropathy