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Polycystic kidneys (synonym: Congenital polycystic kidneys)’”A Rare Disease

Introduction: Polycystic kidneys are hereditary and can be transmitted by either parent as an autosomal dominant trait. The disease is usually not detectable on standard imaging until the 2nd and 3rd decades of life and does not usually manifest itself clinically before the age of 30 years.

Pathology: The kidneys become enormously enlarged, the cysts giving the appearance of a collection of bubbles below the renal capsule. On histological section, the renal parenchyma is riddled with cysts of varying size containing clear fluid, thick brown material or coagulated blood. In 18% of cases there is a congenital cystic liver disease. The pancreas and lungs are occasionally affected as well. The etiology of all renal cysts is uncertain although theories abound.

Clinical features:

Uraemia: Patients with congenital cystic kidneys pass large volumes of urine of low specific gravity (1.010 or less) which contains a trace of albumin but no casts or cells. Chronic renal failure develops as functioning renal tissue is replaced progressively by cysts. The patient complains of anorexia, headache and vague abdominal discomfort. As the symptoms are non-specific, the diagnosis may be missed until drowsiness and vomiting result from the biochemical derangement. Severe anaemia is common. Signs of end-stage renal failure often begin suddenly during middle life, and the patient is unlikely to survive without renal replacement by dialysis or renal transplantation.

Case report: A 35 years old male presenting with pain in both loins. His pain first appeared on the right side 4 years ago which was treated with some allopathic medicines and the pain subsided. There was burning in the part since then and no diagnosis was made. He had pain in left loin 11 days ago.

Past history- He had jaundice 10 years ago.

-Chicken pox 4 years ago

Family history- Mother-alive-Hypertension

Father-died-Polycystic kidney disease

Grandfather-died-Polycystic kidney disease

Uncle-died-Polycystic kidney disease

Brother -died-Polycystic kidney disease

Brother-alive-Polycystic kidney disease

Brother-alive-Renal mass

Sister-died-Polycystic kidney disease hernia

Son-alive-Bilateral inguinal hernia

Generalities:

Appetite: Good, can’t wait for food when hungry. Flatulence if he not eat for long

Desire: Salty food, eggs, very warm food

Thirst: Profuse, large quantities at a time

Tongue: Coated, moist

Sleep: Wakes due to slightest noise and lies on back

Stool: Regular, twice a day

Urine: Comes in drops

Mental generals: Irritable, consolation aggravates. Desire to travel. MISER. Does not work.

USG report  and family history suggested POLYCYSTIC KIDNEY DISEASE.

On the basis of the following symptoms:–

Lycopodium was the medicine selected and was given in fifty millesimal potency three times daily on 11.10.09

Follow up:

19.10.09 – Burning in loin was relieved. Urine now comes in proper flow and quantity increased. Distension of abdomen was relieved.

Lycopodium was given in 0/2 to 0/9 and another USG was done on 24.2.10

Analysis:

Date Right kidney Left kidney
5.10.09191mm194mm
24.2.10195mm175mm

There was marked reduction in size of left kidney and complaints of the patient i.e. pain and burning in loin, scanty urination, distension and flatulence of abdomen subsided. The patient feels healthy, has a good appetite and further rapid progression of cyst formation is restricted with only homeopathic treatment, which is always evident otherwise. This case also proves the fact that constitutional treatment gives good results in rare diseases like POLYCYSTIC KIDNEY DISEASE.