Skip to main content

Main menu

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Podcasts
    • Subject Collections
    • Archives
    • ASN Meeting Abstracts
    • Saved Searches
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprint Information
  • Trainees
    • Peer Review Program
    • Prize Competition
  • About CJASN
    • About CJASN
    • Editorial Team
    • CJASN Impact
    • CJASN Recognitions
  • More
    • Alerts
    • Advertising
    • Reprint Information
    • Subscriptions
    • Feedback
  • ASN Kidney News
  • Other
    • JASN
    • Kidney360
    • Kidney News Online
    • American Society of Nephrology

User menu

  • Subscribe
  • My alerts
  • Log in
  • My Cart

Search

  • Advanced search
American Society of Nephrology
  • Other
    • JASN
    • Kidney360
    • Kidney News Online
    • American Society of Nephrology
  • Subscribe
  • My alerts
  • Log in
  • My Cart
Advertisement
American Society of Nephrology

Advanced Search

  • Home
  • Content
    • Published Ahead of Print
    • Current Issue
    • Podcasts
    • Subject Collections
    • Archives
    • ASN Meeting Abstracts
    • Saved Searches
  • Authors
    • Submit a Manuscript
    • Author Resources
    • Reprint Information
  • Trainees
    • Peer Review Program
    • Prize Competition
  • About CJASN
    • About CJASN
    • Editorial Team
    • CJASN Impact
    • CJASN Recognitions
  • More
    • Alerts
    • Advertising
    • Reprint Information
    • Subscriptions
    • Feedback
  • ASN Kidney News
  • Visit ASN on Facebook
  • Follow CJASN on Twitter
  • CJASN RSS
  • Community Forum

About the Cover

August 07, 2020; Volume 15,Issue 8

Cover image

Cover image expansion

On the Cover

What is the diagnosis?

A 32-year-old male presented for initial evaluation of CKD with a history significant for Fabry disease. Past medical history was notable for irritable bowel syndrome, painful neuropathy of his extremities, and anhidrosis. On examination, blood pressure was 110/74 mmHg; there was no flank tenderness. Serum creatinine was 0.64 mg/dl. Urine dipstick was positive for protein of 100mg/dl but otherwise bland.

Image Description:

A screening renal ultrasound showed multiple anechoic lesions in the renal sinus with no connection to the ureter, which was initially characterized as moderate bilateral hydronephrosis (Left). Magnetic resonance imaging (MRI) with gadolinium was performed to further evaluate the presence of obstruction. This revealed multiple bilateral T2 hyperintense parapelvic cysts without communication with the collecting system (Center). These were non-enhancing cystic lesions along the renal sinuses without evidence of contrast filling on T1 delayed postcontrast imaging (Right). There was no obstructing calculus or hydronephrosis, and the corresponding findings on the ultrasound were attributed to the bilateral renal sinus cysts discovered on MRI.

Teaching Points:

Parapelvic cysts are common in Fabry disease, with an estimated prevalence of 29%–43%, significantly higher than the approximately 1% estimated prevalence in the general population; but they are not specific to this condition. They are often misdiagnosed as hydronephrosis due to the hypoechoic character by ultrasonography and the location in the renal sinus. When asymptomatic hydronephrosis is noted by ultrasonography without identifiable obstructive lesions in patients with Fabry disease, the possibility of parapelvic cysts should be considered.

Disclaimer:

The views expressed herein are those of the authors and do not reflect the official policy of the Departments of Army, Navy, Air Force, Department of Defense, or US Government.

(Images and text provided by Richard Plasse, DO, Megha Joshi, DO, Robert Nee, MD, and Maura Watson, DO, MPH, Nephrology Service, Walter Reed National Military Medical Center, Bethesda, MD, and Department of Medicine, Uniformed Services University, Bethesda, MD; and Nathan Bumbarger, Radiology Service, Walter Reed National Military Medical Center, Bethesda, MD.)

Back to top
PreviousNext

In this issue

Clinical Journal of the American Society of Nephrology: 15 (8)
Clinical Journal of the American Society of Nephrology
Vol. 15, Issue 8
August 07, 2020
  • Table of Contents
  • Table of Contents (PDF)
  • About the Cover
  • Index by author
Sign up for alerts
View Selected Citations (0)

Jump to

  • Patient Voice
  • Editorials
  • Original Articles
    • Chronic Kidney Disease
    • Glomerular and Tubulointerstitial Diseases
    • Hypertension
    • Maintenance Dialysis
    • Nephrolithiasis
    • Transplantation
  • Research Letters
  • Genomics of Kidney Disease
  • Kidney Case Conference: Nephrology Quiz and Questionnaire
  • Perspectives
  • Features
  • Most Read
Loading
  • Revisiting Filtration Fraction as an Index of the Risk of Hemofilter Clotting in Continuous Venovenous Hemofiltration
  • Mitigating Risk of COVID-19 in Dialysis Facilities
  • COVID-19 and the Inpatient Dialysis Unit
  • COVID-19 in Patients with Kidney Disease
  • Sound Science before Quick Judgement Regarding RAS Blockade in COVID-19
More...

Articles

  • Current Issue
  • Early Access
  • Subject Collections
  • Article Archive
  • ASN Meeting Abstracts

Information for Authors

  • Submit a Manuscript
  • Trainee of the Year
  • Author Resources
  • ASN Journal Policies
  • Reuse/Reprint Policy

About

  • CJASN
  • ASN
  • ASN Journals
  • ASN Kidney News

Journal Information

  • About CJASN
  • CJASN Email Alerts
  • CJASN Key Impact Information
  • CJASN Podcasts
  • CJASN RSS Feeds
  • Editorial Board

More Information

  • Advertise
  • ASN Podcasts
  • ASN Publications
  • Become an ASN Member
  • Feedback
  • Follow on Twitter
  • Password/Email Address Changes
  • Subscribe

© 2021 American Society of Nephrology

Print ISSN - 1555-9041 Online ISSN - 1555-905X

Powered by HighWire