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March 1978

Adult or Infantile Polycystic Disease?

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Arch Intern Med. 1978;138(3):497. doi:10.1001/archinte.1978.03630270101038

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To the Editor.—  In a recent issue of the Archives (137:1625-1626, 1977), Piering et al presented a case report of infantile polycystic kidney disease in a 27-year-old woman. They arrived at their diagnosis even though their patient reached adulthood harboring a disease that is almost invariably fatal during childhood or adolescence, and in spite of the fact that their patient demonstrated no evidence of hepatic fibrosis, a universal accompaniment of infantile polycystic disease. Moreover, the illustration of the intravenous urogram that accompanied their paper failed to demonstrate the expected "streaky" nephrogram found in infantile polycystic disease, but instead suggested the presence of multiple renal masses, a finding more in keeping with the adult variety of the disorder. Therefore, I believe there is reason to question the diagnosis that they have put forth.The authors do mention the possibility of adult polycystic disease, but dismiss it, as far as I can

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