Bacterial Cholangitis in Autosomal Dominant Polycystic Kidney and Liver Disease

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Title: Bacterial Cholangitis in Autosomal Dominant Polycystic Kidney and Liver Disease
Authors: Martin, William P.Vaughan, Lisa E.Yoshida, Kotaroet al.
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Date: Jun-2019
Online since: 2021-11-29T12:57:46Z
Abstract: To describe first episodes of bacterial cholangitis complicating autosomal dominant polycystic kidney disease (ADPKD) and autosomal dominant polycystic liver disease (ADPLD) and to identify risk factors for cholangitis episodes among patients with ADPKD-associated polycystic liver disease (PLD). We searched the electronic medical records at our tertiary referral center for episodes of cholangitis in patients with ADPKD or ADPLD from January 1, 1996, through June 30, 2017. Cases were categorized as suspected or definite cholangitis by expert review. Clinical, laboratory, and radiologic data were manually abstracted. A nested case-control study was conducted to investigate risk factors for cholangitis in patients with ADPKD. We identified 29 cases of definite or suspected cholangitis complicating PLD (24 with ADPKD-associated PLD and 5 with ADPLD). Among patients with definite cholangitis in ADPKD-associated PLD (n=19) vs ADPLD (n=4), the mean ± SD age was 62.4±12.2 vs 55.1±8.6 years, and 9 (47.4%) vs 0 (0%), respectively, were male. The odds of gallstones (odds ratio [OR], 21.6; 95% CI, 3.17-927; P<.001), prior cholecystectomy (OR, 12.2; 95% CI, 1.59-552; P=.008), duodenal diverticulum (OR, 13.5; 95% CI, 2.44 to not estimable; P=.004), type 2 diabetes mellitus (OR, 6.41; 95% CI, 1.01 to not estimable; P=.05), prior endoscopic retrograde cholangiopancreatography (OR, 14.0; 95% CI, 1.80-631; P=.005), and prior kidney transplant (OR, 8.06; 95% CI, 1.72-76.0; P=.004) were higher in patients with ADPKD-associated PLD with definite cholangitis compared to controls. Gallstones, prior cholecystectomy, duodenal diverticulosis, type 2 diabetes mellitus, prior endoscopic retrograde cholangiopancreatography, and prior kidney transplant constituted risk factors for cholangitis among patients with ADPKD-associated PLD.
Type of material: Journal Article
Publisher: Elsevier
Journal: Mayo Clinic Proceedings
Volume: 3
Issue: 2
Start page: 149
End page: 159
Copyright (published version): 2019 Mayo Foundation for Medical Education and Research
Keywords: Polycystic liver diseaseHepatic cystsIntrahepatic bile duct dilatationRecurrent cholangitis
DOI: 10.1016/j.mayocpiqo.2019.03.004
Language: en
Status of Item: Peer reviewed
ISSN: 2542-4548
This item is made available under a Creative Commons License:
Appears in Collections:Conway Institute Research Collection
Medicine Research Collection

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