第3巻 2007年2月　第1号

■症例報告

多発性嚢胞腎に合併した急性大動脈解離の3例
中村　有希¹, 四倉　寛子¹, 加藤　雅彦¹, 中田　淳², 田中　啓治², 林　宏光^3
1日本医科大学6年生
²日本医科大学付属病院集中治療室
³日本医科大学付属病院放射線科

Acute Aortic Dissection Associated with Adult Autosomal Dominant Polycystic Kidney Disease: Three Case Reports and a Review
Yuki Nakamura¹, Hiroko Yotsukura¹, Masahiko Kato¹, Jun Nakat², Keiji Tanaka² and Hiromitsu Hayashi^3
1Sixth-year Medical Student, Nippon Medical School
²Division of Intensive and Coronary Care Unit, Nippon Medical School Hospital
³Department of Radiology, Nippon Medical School Hospital

Adult autosomal dominant polycystic kidney disease (ADPKD) is a common hereditary disorder responsible for 8% to 10% of cases of end-stage chronic renal failure. The extrarenal complications of ADPKD kidney include cardiovascular disorders (such as mitral valve prolapse syndrome, bicuspid aortic valve, aortic coarctation, aortic aneurysm, and aortic dissection), intracranial aneurysms, diverticulum of colon, hepatic cysts, inguinal hernia, and urinary calculus. Acute aortic dissection (AAD) associated with ADPKD is life-threatening. There are few reports of ADPKD with AAD. To the best of our knowledge, only 9 cases have been found, including at autopsy, in Japan. We have treated 121 patients with AAD in the last 5 years, and 3 of these 121 patients also had ADPKD in the intensive care unit of Nippon Medical School. We report clinical features of cases of ADPKD with AAD on the basis of 12 cases, including 9 previously reported cases and our 3 cases. AAD requires urgent antihypertensive therapy, which often aggravates renal function. Priority should be given to antihypertensive therapy in emergent cases. In fact, 2 of our patients required hemodialysis owing to antihypertensive therapy for AAD. Close cooperation between cardiologists and nephrologists is essential.

日医大医会誌 2007; 3(1), 25-29

Key words
adult autosomal dominant polycystic kidney disease, acute aortic dissection, hemodialysis

Correspondence to
Keiji Tanaka, MD, PhD, FJCC, Division of Intensive and Coronary Care Unit, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
E-mail：k-tanaka@nms.ac.jp

受付：2006年8月22日　受理：2006年11月21日