1 Division of Cardiology and 2 Division of Clinical Nephrology, Department of Internal Medicine and 3 Institute of Radiology II, Innsbruck University Hospital, Innsbruck, Austria
Correspondence and offprint requests to: Dr G. Pölzl, Division of Cardiology, Department of Internal Medicine, Innsbruck University Hospital, Anichstrasse 35, 6020 Innsbruck, Austria. Email: gerhard.poelzl{at}uklibk.ac.at
Keywords: Eisenmenger's syndrome; pulmonary hypertension; renal capsule; renal compression
Introduction
Eisenmenger's syndrome results from congenital heart disease with a large left to right shunt causing systemic blood pressure in the pulmonary circulation. In addition to severe pulmonary hypertension, these patients have reduced arterial oxygen saturation and polycythaemia. Kidney function may be impaired and proteinuria is frequently found [1]. Renal histology shows glomerulomegaly, mesangial expansion and focal segmental glomerulosclerosis [2].
Case
A 40-year-old man with Eisenmenger's syndrome due to ventricular septal defect presented with a solid painless mass in the left abdomen. A computed tomography scan demonstrated bilateral perirenal fluid in the subcapsular space (Figure 1A). The inferior aspect of the left kidney appeared compressed by a massive anterior cystic formation (Figure 1B). A 24 h urine collection showed 1.3 g proteinuria and a creatinine clearance of 64 ml/min. Haematocrit was 73.7%, PO2 was 41.6 mmHg and blood pressure was 140/100 mmHg.
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Conflict of interest statement. None declared.
References