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polycystic kidney disease |
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Polycystic Kidney Disease DefinitionPolycystic kidney disease (PKD) is one of the most common of all life-threatening human genetic disorders. It is an incurable genetic disorder characterized by the formation of fluid-filled cysts in the kidneys of affected individuals. These cysts multiply over time. It was originally believed that the cysts eventually caused kidney failure by crowding out the healthy kidney tissue. It is now thought that the kidney damage seen in PKD is actually the result of the body's immune system. The immune system, in its attempts to rid the kidney of the cysts, instead progressively destroys the formerly healthy kidney tissue. DescriptionA healthy kidney is about the same size as a human fist. PKD cysts, which can be as small as the head of a pin or as large as a grapefruit, can expand the kidneys until each one is bigger than a football and weighs as much as 38lb (17 kg). There are two types of PKD: infantile PKD, which generally shows symptoms prior to birth; and adult onset PKD. Individuals affected with infantile PKD are often stillborn. Among the liveborn individuals affected with infantile PKD, very few of these children survive to the age of two. The adult onset form of PKD is much more common. The time and degree of symptom onset in the adult form of PKD can vary widely, even within a single family with two or more affected individuals. Symptoms of this form of PKD usually start to appear between the ages of 20 and 50. Organ deterioration progresses more slowly in adult onset PKD than it does in the infantile form; but, if left untreated, adult onset PKD also eventually leads to kidney failure. One of the most common of all life-threatening genetic diseases, PKD affects more than 60,000 Americans. Over 12.5 million people worldwide are affected with PKD. Approximately one in every 400 to 1,000 people is affected with ADPKD. Another one in 10,000 affected with ARPKD. PKD is observed in equal numbers in both males and females. PKD is also observed with equal frequency among ethnic groups. Causes and symptomsPolycystic kidney disease is expressed as both a recessive and a dominant trait. A recessive genetic trait will not cause disease in a child unless it it inheritied from both parents. A dominant genetic trait can be inherited from just one parent. Those people affected with autosomal dominant PKD (ADPKD) have the much more common adult onset form. Those with autosomal recessive PKD (ARPKD) have the infantile form. There are mutations on at least three genes that cause adult onset PKD. Approximately 85% of these cases are known to arise from mutations in the PKD1 gene that has been mapped to a region on the short arm of chromosome 16 (16p13.3-p13.12). Another 10-15% of cases of adult onset PKD are thought to be caused by mutations in the PKD2 gene that has been mapped to a region on the long arm of chromosome 4 (4q21-q23). As of early 2001, it is thought that the remainder of the cases of PKD are caused by mutations in the PKD3 gene, which has not yet been mapped. This unidentified "PKD3 gene" may, in fact, be more than one gene. Adult onset PKD is transmitted from parents to their offspring as a non-sex linked (autosomal) dominant trait. This means that if either parent carries this genetic mutation, there is a 50% chance that their child will inherit this disease. In the case of two affected parents, there is a 75% probability that their children will be affected with adult onset PKD. Infantile PKD is caused by a non-sex linked (autosomal) recessive genetic mutation that has been mapped to a region on the short arm of chromosome 6 (6p21). Both parents must be carriers of this mutation for their children to be affected with infantile PKD. In the case of two carrier parents, the probability is 25% that their child will be affected by infantile PKD. A baby born with infantile PKD has floppy, low-set ears, a pointed nose, a small chin, and folds of skin surrounding the eyes (epicanthal folds). Large, rigid masses can be felt on the back of both thighs (flanks), and the baby usually has trouble breathing. In the early stages of adult onset PKD, many people show no symptoms. Generally, the first symptoms to develop are: high blood pressure (hypertension); general fatigue; pain in the lower back or the backs of the thighs; headaches; and/or urinary tract infections accompanied by frequent urination. As PKD becomes more advanced, the kidneys' inability to function properly becomes more pronounced. The cysts on the kidney may begin to rupture and the kidneys tend to be much larger than normal. Individuals affected with PKD have a much higher rate of kidney stones than the rest of the population at this, and later stages, of the disease. Approximately 60% of those individuals affected with PKD develop cysts in the liver, while 10% develop cysts in the pancreas. Because the kidneys are primarily responsible for cleaning the blood, individuals affected with PKD often have problems involving the circulatory system. These include: an underproduction of red blood cells which results in an insufficient supply of oxygen to the tissues and organs (anemia); an enlarged heart (cardiac hypertrophy) probably caused by long term hypertension; and, a leakage of the valve between the left chambers (auricle and ventricle) of the heart (mitral valve prolapse). Less common (affecting approximately 5% of PKD patients) are brain aneurysms. An aneurysm is an abnormal and localized bulging of the wall of a blood vessel. If an aneurysm within the brain leaks or bursts, it may cause a stroke or even death. Other health problems associated with adult onset PKD include: chronic leg or back pain; frequent infections; and herniations of the groin and abdomen, including herniation of the colon (diverticular disease). A herniation, or hernia, is caused when a tissue, designed to hold the shape of an underlying tissue, becomes weakened at a particular spot. The underlying tissue pushes against this weakened area until the area is no longer able to hold back the underlying tissue and the area forms an abnormal bulge through which the underlying tissue projects. Diverticular disease is caused by a weakening of the muscles that hold the shape of the organs of the digestive tract. These muscles weaken allowing these organs, particularly one section of the colon, to form sac-like projections that can trap feces and become infected, or rupture. In the final stages of PKD, the major symptom is kidney (renal) failure. Renal failure is indicated by an increase of nitrogen (in the form of urea) in the blood (uremia, or uremic poisoning). Uremia is a rapidly fatal condition without treatment. DiagnosisMany patients who have PKD do not have any symptoms. Their condition may not be discovered unless tests that detect it are performed for other reasons. When symptoms of PKD are present, the diagnostic procedure begins with a family medical history and physical examination of the patient. If several family members have PKD, there is a strong likelihood that the patient has it too. If the disease is advanced, the doctor will be able to feel the patient's enlarged kidneys. Heart murmur, high blood pressure, and other signs of cardiac impairment can also be detected. Urinalysis and a blood test called creatine clearance can indicate how effectively the kidneys are functioning. Scanning procedures using intravenous dye reveal kidney enlargement or deformity and scarring caused by cysts. Ultrasound and computed tomography scans (CT scans) can reveal kidney enlargement and the cysts that caused it. CT scans can highlight cyst-damaged areas of the kidneys. A sampling of the kidney cells (biopsy) may be performed to verify the diagnosis. TreatmentThere is no way to prevent cysts from forming or becoming enlarged, or to prevent PKD from progressing to kidney failure. Treatment goals include preserving healthy kidney tissue; controlling symptoms and, preventing infection and other complications. If adult PKD is diagnosed before symptoms become evident, urinalysis and other diagnostic tests are performed at six-week intervals to monitor the patient's health status. If results indicate the presence of infection or another PKD-related health problem, aggressive antibiotic therapy is initiated to prevent inflammation that can accelerate disease progression; iron supplements or infusion of red blood cells are used to treat anemia; and surgery may be needed to drain cysts that bleed, cause pain, have become infected, or interfere with normal kidney function. Lowering high blood pressure can slow loss of kidney function. Blood-pressure control, which is the cornerstone of PKD treatment, is difficult to achieve. Therapy may include antihypertensive medications, diuretic medications, and/or a low-salt diet. As kidney function declines, some patients need dialysis and/or a kidney transplant. There is no known way to prevent PKD, but certain lifestyle modifications can help control symptoms. People who have PKD should not drink heavily or smoke. They should not use aspirin, non-steroidal anti-inflammatory drugs (NSAIDs), or other prescription or over-the-counter medications that can impair kidney function. Individuals affected with PKD should eat a balanced diet, exercise regularly, and maintain a weight appropriate for their height, age, and body type. Regular medical monitoring is also recommended. PrognosisThere is no known cure for PKD. Those affected with infantile PKD generally die before the age of two. In adults, untreated disease can be rapidly fatal or continue to progress slowly, even after symptoms of kidney failure appear. About half of all adults with PKD also develop kidney failure. Unless the patient undergoes dialysis or has a kidney transplant, this condition usually leads to death within four years of diagnosis. Although medical treatment can temporarily alleviate symptoms of PKD, the expanding cysts continue to increase pressure on the kidneys. Kidney failure and uremic poisoning (accumulation of waste products the body is unable to eliminate) generally cause death about 10 years after symptoms first appear. Medications used to fight cancer and reduce elevated cholesterol levels have slowed the advance of PKD in laboratory animals. They may soon be used to treat adults and children who have the disease. Researchers are also evaluating the potential benefits of anti-inflammatory drugs, which may prevent the scarring that destroys kidney function. ResourcesPeriodicalsKoptides, M., and C. Deltas. "Autosomal dominant polycystic kidney disease: Molecular genetics and molecular pathogenesis." Human Genetics August 2000: 115-26. Pei, Y., A. Paterson, K. Wang, N. He, et al. "Bilineal disease and trans-heterozygotes in autosmal dominant polycystic kidney disease." American Journal of Human Genetics February 2001: 355-63. OrganizationsPolycystic Kidney Disease Foundation. 4901 Main Street, Kansas City, MO 64112-2634. (800) PKD-CURE. 〈http://www.pkdcure.org/home.htm〉. OtherBrochert, Adam, MD. "Polycystic Kidney Disease." September 4, 2000. HealthAnswers. 〈http://www.healthanswers.com/library/library_fset.asp〉. Cooper, Joel R. "Treating Polycystic Kidney Disease. What Does the Future Hold?" Coolware, Inc. http://www.coolware.com/health/medical_reporter/kidney1.html. Online Mendelian Inheritance in Man (OMIM). February 15, 2001. http://www.ncbi.nlm.nih.gov/htbin-post/Omim/dispmim?600595. Polycystic Kidney Disease Access Center. http://www.nhpress.com/pkd/. Key termsBiopsy — The surgical removal and microscopic examination of living tissue for diagnostic purposes. Cancer — A disease caused by uncontrolled growth of the body's cells. Computed tomography (CT) scan — An imaging procedure that produces a three-dimensional picture of organs or structures inside the body, such as the brain. Cyst — An abnormal sac or closed cavity filled with liquid or semisolid matter. Diuretics — Medications that increase the excretion of urine. Kidney — Either of two organs in the lumbar region that filter the blood, excreting the end products of the body's metabolism in the form of urine and regulating the concentrations of hydrogen, sodium, potassium, phosphate and other ions in the body. Magnetic resonance imaging (MRI) — A technique that employs magnetic fields and radio waves to create detailed images of internal body structures and organs, including the brain. Ultrasonogram — A procedure where high-frequency sound waves that cannot be heard by human ears are bounced off internal organs and tissues. These sound waves produce a pattern of echoes, which are then used by the computer to create sonograms or pictures of areas inside the body. Uremic poisoning — Accumulation of waste products in the body. disease /dis·ease/ (dĭ-zēz´) any deviation from or interruption of the normal structure or function of any body part, organ, or system that is manifested by a characteristic set of symptoms and signs and whose etiology, pathology, and prognosis may be known or unknown. See also entries under syndrome. acquired cystic disease of kidney the development of cysts in the formerly noncystic failing kidney in end-stage renal disease. Addison's disease bronzelike pigmentation of the skin, severe prostration, progressive anemia, low blood pressure, diarrhea, and digestive disturbance, due to adrenal hypofunction. Albers-Schönberg disease osteopetrosis. allogeneic disease graft-versus-host reaction occurring in immunosuppressed animals receiving injections of allogeneic lymphocytes. Alpers' disease a rare disease of young children, characterized by neuronal deterioration of the cerebral cortex and elsewhere, progressive mental deterioration, motor disturbances, seizures, and early death. alpha chain disease heavy chain disease characterized by plasma cell infiltration of the lamina propria of the small intestine resulting in malabsorption with diarrhea, abdominal pain, and weight loss, possibly accompanied by pulmonary involvement. Alzheimer's disease progressive degenerative disease of the brain, of unknown cause; characterized by diffuse atrophy throughout the cerebral cortex with distinctive histopathological changes. Andersen's disease glycogen storage d., type IV. apatite deposition disease a connective tissue disorder marked by deposition of hydroxyapatite crystals in one or more joints or bursae. Aran-Duchenne disease spinal muscular atrophy. arteriosclerotic cardiovascular disease (ASCVD) atherosclerotic involvement of arteries to the heart and to other organs, resulting in debility or death; sometimes used specifically for ischemic heart disease. arteriosclerotic heart disease (ASHD) ischemic heart d. autoimmune disease any of a group of disorders in which tissue injury is associated with humoral or cell-mediated responses to the body's own constituents; they may be systemic or organ-specific. Ayerza's disease polycythemia vera with chronic cyanosis, dyspnea, bronchitis, bronchiectasis, hepatosplenomegaly, bone marrow hyperplasia, and pulmonary artery sclerosis. Banti's disease congestive splenomegaly. Barlow disease scurvy in infants. Barraquer's disease partial lipodystrophy. Basedow's disease Graves' d. Batten disease , Batten-Mayou disease 2. more generally, any or all of the group of disorders constituting neuronal ceroid lipofuscinosis. Bayle's disease general paresis. Bazin's disease erythema induratum. Bekhterev's (Bechterew's) disease ankylosing spondylitis. Benson's disease asteroid hyalosis. Berger's disease IgA glomerulonephritis. Bernhardt's disease , Bernhardt-Roth disease meralgia paresthetica. Besnier-Boeck disease sarcoidosis. Best's disease congenital macular degeneration. Bielschowsky-Janský disease Janský-Bielschowsky d. Binswanger's disease a degenerative dementia of presenile onset caused by demyelination of the subcortical white matter of the brain. black disease a fatal disease of sheep, and sometimes of humans, in the United States and Australia, due to Clostridium novyi, marked by necrotic areas in the liver. Blocq's disease astasia-abasia. Blount disease tibia vara. Boeck's disease sarcoidosis. Bornholm disease epidemic pleurodynia. Bowen's disease a squamous cell carcinoma in situ, often due to prolonged exposure to arsenic; usually occurring on sun-exposed areas of skin. The corresponding lesion on the glans penis is termed erythroplasia of Queyrat. Brill's disease Brill-Zinsser d. Brill-Symmers disease giant follicular lymphoma. Brill-Zinsser disease mild recrudescence of epidemic typhus years after the initial infection, because Rickettsia prowazekii has persisted in body tissue in an inactive state, with humans as the reservoir. broad beta disease familial dysbetalipoproteinemia; named for the electrophoretic mobility of the abnormal chylomicron and very-low-density lipoprotein remnants produced. Busse-Buschke disease cryptococcosis. Caffey's disease infantile cortical hyperostosis. calcium hydroxyapatite deposition disease apatite deposition d. calcium pyrophosphate deposition disease (CPDD) an acute or chronic inflammatory arthropathy caused by deposition of calcium pyrophosphate dihydrate (CPPD) crystals in the joints, chondrocalcinosis, and crystals in the synovial fluid. Acute attacks are sometimes called pseudogout. Calvé-Perthes disease osteochondrosis of capitular epiphysis of femur. Camurati-Engelmann disease diaphyseal dysplasia. Canavan disease , Canavan-van Bogaert-Bertrand disease spongy degeneration of the central nervous system. Carrión's disease bartonellosis. Castleman disease a benign or premalignant condition resembling lymphoma but without recognizable malignant cells; there are isolated masses of lymphoid tissue and lymph node hyperplasia, usually in the abdominal or mediastinal area. cat-scratch disease a usually benign, self-limited disease of the regional lymph nodes, caused by Bartonella henselae and characterized by a papule or pustule at the site of a cat scratch, subacute painful regional lymphadenitis, and mild fever. celiac disease a malabsorption syndrome precipitated by ingestion of gluten-containing foods, with loss of villous structure of the proximal intestinal mucosa, bulky, frothy diarrhea, abdominal distention, flatulence, weight loss, and vitamin and electrolyte depletion. Chagas disease trypanosomiasis due to Trypanosoma cruzi; its course may be acute, subacute, or chronic. Charcot-Marie-Tooth disease muscular atrophy of variable inheritance, beginning in the muscles supplied by the peroneal nerves and progressing to those of the hands and arms. cholesteryl ester storage disease (CESD) a lysosomal storage disease due to deficiency of lysosomal cholesterol esterase, variably characterized by some combination of hepatomegaly, hyperbetalipoproteinemia, and premature atherosclerosis. Christmas disease hemophilia B. chronic granulomatous disease frequent, severe infections of the skin, oral and intestinal mucosa, reticuloendothelial system, bones, lungs, and genitourinary tract associated with a genetically determined defect in the intracellular bactericidal function of leukocytes. chronic obstructive pulmonary disease (COPD) any disorder marked by persistent obstruction of bronchial air flow. Coats' disease exudative retinopathy. collagen disease any of a group of diseases characterized by widespread pathologic changes in connective tissue; they include lupus erythematosus, dermatomyositis, scleroderma, polyarteritis nodosa, thrombotic purpura, rheumatic fever, and rheumatoid arthritis. Cf. collagen disorder. communicable disease a disease the causative agents of which may pass or be carried from one person to another directly or indirectly. Concato's disease progressive malignant polyserositis with large effusions into the pericardium, pleura, and peritoneum. constitutional disease one involving a system of organs or one with widespread symptoms. Cori's disease glycogen storage d., type III. coronary artery disease (CAD) atherosclerosis of the coronary arteries, which may cause angina pectoris, myocardial infarction, and sudden death; risk factors include hypercholesterolemia, hypertension, smoking, diabetes mellitus, and low levels of high-density lipoproteins. coronary heart disease (CHD) ischemic heart d. Cowden disease a hereditary disease marked by multiple ectodermal, mesodermal, and endodermal nevoid and neoplastic anomalies. Creutzfeldt-Jakob disease a rare prion disease existing in sporadic, familial, and infectious forms, with onset usually in middle life, and having a wide variety of clinical and pathological features. The most commonly seen are spongiform degeneration of neurons, neuronal loss, gliosis, and amyloid plaque formation, accompanied by rapidly progressive dementia, myoclonus, motor disturbances, and encephalographic changes, with death occurring usually within a year of onset. Crigler-Najjar disease see under syndrome. Crohn's disease regional enteritis; a chronic granulomatous inflammatory disease usually in the terminal ileum with scarring and thickening of the wall, often leading to intestinal obstruction and formation of fistulas and abscesses. Crouzon's disease craniofacial dysostosis. Cruveilhier's disease spinal muscular atrophy. Cushing's disease Cushing's syndrome in which the hyperadrenocorticism is secondary to excessive pituitary secretion of adrenocorticotropic hormone. cystic disease of breast mammary dysplasia with formation of blue dome cysts. cytomegalic inclusion disease , cytomegalovirus disease an infection due to cytomegalovirus and marked by nuclear inclusion bodies in enlarged infected cells. In the congenital form, there is hepatosplenomegaly with cirrhosis, and microcephaly with mental or motor retardation. Acquired disease may cause a clinical state similar to infectious mononucleosis. When acquired by blood transfusion, postperfusion syndrome results. deficiency disease a condition caused by dietary or metabolic deficiency, including all diseases due to an insufficient supply of essential nutrients. degenerative joint disease osteoarthritis. Dejerine's disease , Dejerine-Sottas disease progressive hypertrophic neuropathy. demyelinating disease any condition characterized by destruction of the myelin sheaths of nerves. disappearing bone disease gradual resorption of a bone or group of bones, sometimes associated with multiple hemangiomas, usually in children or young adults and following trauma. diverticular disease a general term including the prediverticular state, diverticulosis, and diverticulitis. Duchenne's disease 3. tabes dorsalis. Duchenne-Aran disease spinal muscular atrophy. Duhring's disease dermatitis herpetiformis. Dukes' disease a febrile disease of childhood marked by an exanthematous eruption, probably due to a virus of the Coxsackie-ECHO group. Durand-Nicolas-Favre disease lymphogranuloma venereum. Duroziez's disease congenital mitral stenosis. Ebola virus disease fatal acute hemorrhagic fever resembling Marburg virus disease but caused by Ebola virus, seen in the Sudan and Zaire. Ebstein's disease see under anomaly. end-stage renal disease chronic irreversible renal failure. Erb's disease Duchenne's muscular dystrophy. Erb-Goldflam disease myasthenia gravis. Eulenburg's disease paramyotonia congenita. extrapyramidal disease any of a group of clinical disorders marked by abnormal involuntary movements, alterations in muscle tone, and postural disturbances; they include parkinsonism, chorea, athetosis, etc. Fabry's disease an X-linked lysosomal storage disease of glycosphingolipid catabolism resulting from deficiency of α-galactosidase A and leading to accumulation of ceramide trihexoside in the cardiovascular and renal systems. Farber's disease a lysosomal storage disease due to defective ceramidase and characterized by hoarseness, aphonia, dermatitis, bone and joint deformities, granulomatous reaction, and psychomotor retardation. Fazio-Londe disease a rare type of progressive bulbar palsy occurring in childhood. Feer disease acrodynia. fibrocystic disease of breast a form of mammary dysplasia with formation of cysts of various size containing a semitransparent, turbid fluid that imparts a brown to blue color to the unopened cysts; believed due to abnormal hyperplasia of the ductal epithelium and dilatation of the ducts of the mammary gland, resulting from exaggeration and distortion of normal menstrual cycle–related breast changes. fibrocystic disease of the pancreas cystic fibrosis. fifth disease erythema infectiosum. flint disease chalicosis. floating beta disease familial dysbetalipoproteinemia. focal disease a localized disease. foot-and-mouth disease an acute, contagious viral disease of wild and domestic cloven-footed animals and occasionally humans, marked by vesicular eruption on the lips, buccal cavity, pharynx, legs, and feet. Forbes' disease glycogen storage d., type III. fourth disease Dukes' d. fourth venereal disease granuloma inguinale. Fox-Fordyce disease a persistent and recalcitrant, itchy, papular eruption, chiefly of the axillae and pubes, due to inflammation of apocrine sweat glands. Freiberg's disease osteochondrosis of the head of the second metatarsal bone. Friedländer's disease endarteritis obliterans. Friedreich's disease paramyoclonus multiplex. functional disease see under disorder. Garré's disease sclerosing nonsuppurative osteomyelitis. gastroesophageal reflux disease (GERD) any condition resulting from gastroesophageal reflux, characterized by heartburn and regurgitation; see also reflux esophagitis. Gaucher's disease a hereditary disorder of glucocerebroside metabolism, marked by the presence of Gaucher's cells in the marrow, and by hepatosplenomegaly and erosion of the cortices of long bones and pelvis. The adult form is associated with moderate anemia and thrombocytopenia, and yellowish pigmentation of the skin; in the infantile form there is, in addition, marked central nervous system impairment; in the juvenile form there are rapidly progressive systemic manifestations but moderate central nervous system involvement. genetic disease a general term for any disorder caused by a genetic mechanism, comprising chromosome aberrations (or anomalies), mendelian (or monogenic or single-gene) disorders, and multifactorial disorders. gestational trophoblastic disease see under neoplasia. Gilbert disease a familial, benign elevation of bilirubin levels without evidence of liver damage or hematologic abnormalities. Gilles de la Tourette's disease see under syndrome. Glanzmann disease see thrombasthenia. glycogen storage disease any of a number of rare inborn errors of metabolism caused by defects in specific enzymes or transporters involved in the metabolism of glycogen. type I glucose-6-phosphatase deficiency: a severe hepatorenal form due to deficiency of the hepatic enzyme glucose-6-phosphatase, resulting in liver and kidney involvement, with hepatomegaly, hypoglycemia, hyperuricemia, and gout type IA glycogen storage d., type I. type IB a form resembling type I but additionally predisposing to infection due to neutropenia and to chronic inflammatory bowel disease; due to a defect in the transport system for glucose 6-phosphate. type II a disorder due to deficiency of the lysosomal enzyme α-1,4,-glucosidase, the severe infant form resulting in generalized glycogen accumulation, with cardiomegaly, cardiorespiratory failure, and death, and a milder adult form being a gradual skeletal myopathy that sometimes causes respiratory problems. type III a form due to deficiency of debrancher enzyme (amylo-1,6-glucosidase) in muscle, liver, or both; defects in the liver enzyme are characterized by hepatomegaly and hypoglycemia while defects in the muscle enzyme are characterized by progressive muscle wasting and weakness. type IV brancher enzyme deficiency; cirrhosis of the liver, hepatosplenomegaly, progressive hepatic failure, and death due to deficiency of the glycogen brancher enzyme (1,4-α-glucan branching enzyme). type V muscle cramps and fatigue during exercise due to a defect in the skeletal muscle isozyme of glycogen phosphorylase (muscle phosphorylase). type VI hepatomegaly, mild to moderate hypoglycemia and mild ketosis, due to deficiency of the liver isozyme of glycogen phosphorylase (hepatic phosphorylase). type VII muscle weakness and cramping after exercise due to deficiency of the muscle isozyme of 6-phosphofructokinase. type VIII phosphorylase . graft-versus-host (GVH) disease disease caused by the immune response of histoincompatible, immunocompetent donor cells against the tissue of immunocompromised host, as a complication of bone marrow transplantation, or as a result of maternal-fetal blood transfusion, or therapeutic transfusion to an immunocompromised recipient. Graves' disease an association of hyperthyroidism, goiter, and exophthalmos, with accelerated pulse rate, profuse sweating, nervous symptoms, psychic disturbances, emaciation, and elevated basal metabolism. Greenfield's disease former name for the late infantile form of metachromatic leukodystrophy. Gull's disease atrophy of the thyroid gland with myxedema. Günther disease congenital erythropoietic porphyria. H disease Hartnup d. Hailey-Hailey disease benign familial pemphigus. Hallervorden-Spatz disease an autosomal recessive disorder caused by decreased numbers of myelin sheaths of the globus pallidus and substantia nigra, with accumulation of iron pigment, progressive rigidity beginning in the legs, choreoathetoid movements, dysarthria, and mental deterioration. Hand's disease Hand-Schüller-Christian d. hand-foot-and-mouth disease a mild, highly infectious viral disease of children, with vesicular lesions in the mouth and on the hands and feet. Hand-Schüller-Christian disease a chronic, progressive form of multifocal Langerhans cell histiocytosis, sometimes with accumulation of cholesterol, characterized by the triad of calvarial bone defects, exophthalmos, and diabetes insipidus. Hansen's disease leprosy. Hartnup disease a hereditary disorder of intestinal and renal transport of neutral α-amino acids, marked by a pellagra-like skin rash, with transient cerebellar ataxia, constant renal aminoaciduria, and other biochemical abnormalities. Hashimoto's disease a progressive disease of the thyroid gland with degeneration of its epithelial elements and replacement by lymphoid and fibrous tissue. heavy chain diseases a group of malignant neoplasms of lymphoplasmacytic cells marked by the presence of immunoglobulin heavy chains or heavy chain fragments; they are classified according to heavy chain type, e.g., alpha chain disease. Heine-Medin disease the major form of poliomyelitis. hemoglobin disease any of various hereditary molecular diseases characterized by abnormal hemoglobins in the red blood cells; the homozygous form is manifested by hemolytic anemia. hemolytic disease of the newborn erythroblastosis fetalis. hemorrhagic disease of the newborn a self-limited hemorrhagic disorder of the first few days of life, due to deficiency of vitamin K–dependent coagulation factors II, VII, IX, and X. Hers' disease glycogen storage d., type VI. Heubner-Herter disease the infantile form of celiac disease. hip-joint disease tuberculosis of the hip joint. Hippel's disease von Hippel's d. Hirschsprung's disease congenital megacolon. His disease , His-Werner disease trench fever. Hodgkin's disease a form of malignant lymphoma marked clinically by painless, progressive enlargement of lymph nodes, spleen, and general lymphoid tissue; other symptoms may include anorexia, lassitude, weight loss, fever, pruritus, night sweats, and anemia. Reed-Sternberg cells are characteristically present. Four types have been distinguished on the basis of histopathologic criteria. hoof-and-mouth disease foot-and-mouth d. hookworm disease infection with the hookworm Ancylostoma duodenale or Necator americanus, whose larvae enter the body through the skin or in contaminated food or water and migrate to the small intestine where, as adults, they attach to the mucosa and ingest blood; symptoms may include abdominal pain, diarrhea, colic or nausea, and anemia. hyaline membrane disease a type of respiratory distress syndrome of the newborn in which there is formation of a hyaline-like membrane lining the terminal respiratory passages; extensive atelectasis is attributed to lack of surfactant. hydatid disease an infection, usually of the liver, due to larval forms of tapeworms of the genus Echinococcus, marked by development of expanding cysts. hypophosphatemic bone disease an inherited disorder resembling a mild form of X-linked hypophosphatemia, similarly due to a defect in renal tubular function but usually showing osteomalacia without radiographic evidence of rickets. immune complex disease local or systemic disease caused by the formation of circulating immune complexes and their deposition in tissue, due to activation of complement and to recruitment and activation of leukocytes in type III hypersensitivity reactions. infectious disease one due to organisms ranging in size from viruses to parasitic worms; it may be contagious in origin, result from nosocomial organisms, or be due to endogenous microflora from the nose and throat, skin, or bowel. inflammatory bowel disease any idiopathic inflammatory disease of the bowel, such as Crohn's disease and ulcerative colitis. intercurrent disease one occurring during the course of another disease with which it has no connection. iron storage disease hemochromatosis. ischemic bowel disease ischemic colitis. ischemic heart disease (IHD) any of a group of acute or chronic cardiac disabilities resulting from insufficient supply of oxygenated blood to the heart. Janský-Bielschowsky disease the late infantile form of neuronal ceroid lipofuscinosis, occurring between two and four years of age, characterized by abnormal accumulation of lipofuscin; beginning as myoclonic seizures and progressing to neurologic and retinal deterioration and death by age 8 to 12. jumping disease any of several culture-specific disorders characterized by exaggerated responses to small stimuli, muscle tics including jumping, obedience even to dangerous suggestions, and sometimes coprolalia or echolalia. juvenile Paget disease hyperostosis corticalis deformans juvenilis. Kashin-Bek (Kaschin-Beck) disease a disabling degenerative disease of the peripheral joints and spine, endemic in northeastern Asia; believed to be caused by ingestion of cereal grains infected with the fungus Fusarium sporotrichiella. Katayama disease schistosomiasis japonica. Kawasaki disease a febrile illness usually affecting infants and young children, with conjunctival injection, changes to the oropharyngeal mucosa, changes to the peripheral extremities including edema, erythema, and desquamation, a primarily truncal polymorphous exanthem, and cervical lymphadenopathy. It is often associated with vasculitis of the large coronary vessels. Kienböck's disease slowly progressive osteochondrosis of the lunate bone; it may affect other wrist bones. kinky hair disease Menkes' syndrome. Köhler's bone disease 1. osteochondrosis of the tarsal navicular bone in children. 2. thickening of the shaft of the second metatarsal bone and changes about its articular head, with pain in the second metatarsophalangeal joint on walking or standing. Krabbe's disease a lysosomal storage disease beginning in infancy, due to deficiency of β-galactosidase. Pathologically, there is rapidly progressive cerebral demyelination and large globoid bodies (swollen with accumulated cerebroside) in the white substance. Kufs' disease the adult form of neuronal ceroid lipofuscinosis, with onset prior to age 40; characterized by progressive neurologic deterioration but not blindness, excessive storage of lipofuscin, and shortened life expectancy; Kümmell's disease compression fracture of vertebra, with symptoms a few weeks after injury, including spinal pain, intercostal neuralgia, lower limb motor disturbances, and kyphosis. Kyasanur Forest disease a fatal viral disease of monkeys in the Kyasanur Forest of India, communicable to humans, in whom it produces hemorrhagic symptoms. Kyrle's disease a chronic disorder of keratinization marked by keratotic plugs that develop in hair follicles and eccrine ducts, penetrating the epidermis and extending down into the corium, causing foreign-body reaction and pain. Lafora's disease see under epilepsy. Leber's disease legionnaires' disease an often fatal bacterial infection caused by Legionella pneumophila, not spread by person-to-person contact, characterized by high fever, gastrointestinal pain, headache, and pneumonia; there may also be involvement of the kidneys, liver, and nervous system. Leiner's disease a disorder of infancy characterized by generalized seborrhea-like dermatitis and erythroderma, severe intractable diarrhea, recurrent infections, and failure to thrive. Leriche disease post-traumatic osteoporosis. Letterer-Siwe disease a Langerhans cell histiocytosis of early childhood, of autosomal recessive inheritance, characterized by cutaneous lesions resembling seborrheic dermatitis, hemorrhagic tendency, hepatosplenomegaly, lymphadenitis, and progressive anemia. If untreated it is rapidly fatal. Called also acute disseminated Langerhans cell histiocytosis. Libman-Sacks disease see under endocarditis. Lindau's disease , Lindau-von Hippel disease von Hippel-Lindau d. Little's disease congenital spastic stiffness of the limbs, a form of cerebral palsy due to lack of development of the pyramidal tracts. Lobstein's disease see osteogenesis imperfecta. Lou Gehrig disease amyotrophic lateral sclerosis. Lowe disease oculocerebrorenal syndrome. Lutz-Splendore-Almeida disease paracoccidioidomycosis. Lyme disease a recurrent multisystemic disorder caused by the spirochete Borrelia burgdorferi, the vectors being the ticks Ixodes scapularis and I. pacificus; usually initially characterized by lesions of erythema chronicum migrans, followed by various manifestations including arthritis of the large joints, myalgia, and neurologic and cardiac abnormalities. lysosomal storage disease an inborn error of metabolism with (1) a defect in a specific lysosomal enzyme; (2) intracellular accumulation of an unmetabolized substrate; (3) clinical progression affecting multiple tissues or organs; (4) considerable phenotypic variation within a disease. MAC disease complex d. McArdle disease glycogen storage d., type V. mad cow disease bovine spongiform encephalopathy. maple bark disease hypersensitivity pneumonitis in logging and sawmill workers due to inhalation of spores of a mold, Cryptostroma corticale, growing under the maple bark. maple syrup urine disease (MSUD) a hereditary enzyme defect in metabolism of branched chain amino acids, marked clinically by mental and physical retardation, severe ketoacidosis, feeding difficulties, and a characteristic maple syrup odor in the urine and on the body. Marburg virus disease a severe, often fatal, viral hemorrhagic fever first reported in Marburg, Germany, among laboratory workers exposed to African green monkeys. Marchiafava-Micheli disease paroxysmal nocturnal hemoglobinuria. Marie-Bamberger disease hypertrophic pulmonary osteoarthropathy. Marie-Strümpell disease ankylosing spondylitis. Marie-Tooth disease Charcot-Marie-Tooth d. Mediterranean disease thalassemia major. medullary cystic disease familial juvenile nephronophthisis. Meniere's disease deafness, tinnitus, and dizziness, in association with nonsuppurative disease of the labyrinth. mental disease see under disorder. Merzbacher-Pelizaeus disease Pelizaeus-Merzbacher d. metabolic disease one caused by a disruption of a normal metabolic pathway because of a genetically determined enzyme defect. Meyer's disease adenoid vegetations of the pharynx. Mikulicz's disease benign, self-limited lymphocytic infiltration and enlargement of the lacrimal and salivary glands of uncertain etiology. Milroy disease hereditary permanent lymphedema of the legs due to lymphatic obstruction. Minamata disease a severe neurologic disorder due to alkyl mercury poisoning, with permanent neurologic and mental disabilities or death; once prevalent among those eating contaminated seafood from Minamata Bay, Japan. minimal change disease subtle alterations in kidney function demonstrable by clinical albuminuria and the presence of lipid droplets in cells of the proximal tubules, seen primarily in young children. mixed connective tissue disease a combination of scleroderma, myositis, systemic lupus erythematosus, and rheumatoid arthritis, and marked serologically by the presence of antibody against extractable nuclear antigen. Möbius disease ophthalmoplegic migraine. molecular disease any disease in which the pathogenesis can be traced to a single molecule, usually a protein, which is either abnormal in structure or present in reduced amounts. Mondor's disease phlebitis affecting the large subcutaneous veins normally crossing the lateral chest wall and breast from the epigastric or hypochondriac region to the axilla. Monge's disease chronic mountain sickness. Morquio's disease , Morquio-Ullrich disease see under syndrome. motor neuron disease , motor system disease any disease of a motor neuron, including spinal muscular atrophy, progressive bulbar paralysis, amyotrophic lateral sclerosis, and lateral sclerosis. Mycobacterium avium complex disease MAC disease; systemic disease caused by infection with organisms of the Mycobacterium avium-intracellulare complex in patients with human immunodeficiency virus infection. Newcastle disease a viral disease of birds, including domestic fowl, transmissible to humans, characterized by respiratory, gastrointestinal or pulmonary, and encephalitic symptoms. new variant Creutzfeldt-Jakob disease (nvCJD) a variant of Creutzfeldt-Jakob disease having a younger age of onset than is seen in Creutzfeldt-Jakob disease, and caused by the same agent that causes bovine spongiform encephalopathy. Nicolas-Favre disease lymphogranuloma venereum. Niemann's disease , Niemann-Pick disease a lysosomal storage disease due to sphingomyelin accumulation in the reticuloendothelial system; there are five types distinguished by age of onset, amount of central nervous system involvement, and degree of enzyme deficiency. nil disease minimal change d. Norrie's disease an X-linked disorder consisting of bilateral blindness from retinal malformation, mental retardation, and deafness. notifiable disease one required to be reported to federal, state, or local health officials when diagnosed, because of infectiousness, severity, or frequency of occurrence. oasthouse urine disease methionine malabsorption syndrome. obstructive small airways disease chronic bronchitis with irreversible narrowing of the bronchioles and small bronchi with hypoxia and often hypercapnia. occupational disease disease due to various factors involved in one's employment. Oguchi's disease a form of hereditary night blindness and fundus discoloration following light adaptation. organic disease one associated with demonstrable change in a bodily organ or tissue. Osgood-Schlatter disease osteochondrosis of the tuberosity of the tibia. Osler's disease Owren's disease parahemophilia. Paget's disease 1. (of bone) osteitis deformans. 2. (of breast) an intraductal inflammatory carcinoma of the breast, involving the areola and nipple. 3. an extramammary counterpart of Paget's disease (2), usually involving the vulva, and sometimes other sites, as the perianal and axillary regions. Parkinson's disease a slowly progressive form of parkinsonism, usually seen late in life, marked by masklike facies, tremor of resting muscles, slowing of voluntary movements, festinating gait, peculiar posture, muscular weakness, and sometimes excessive sweating and feelings of heat. Parrot's disease see under pseudoparalysis. parrot disease psittacosis. Parry's disease Graves' d. Pelizaeus-Merzbacher disease a progressive familial form of leukoencephalopathy, marked by nystagmus, ataxia, tremor, parkinsonian facies, dysarthria, and mental deterioration. Pellegrini's disease , Pellegrini-Stieda disease calcification of the medial collateral ligament of the knee due to trauma. pelvic inflammatory disease (PID) any pelvic infection involving the upper female genital tract beyond the cervix. periodontal disease any disease or disorder of the periodontium. Perthes' disease osteochondrosis of capitular femoral epiphysis. Peyronie's disease induration of the corpora cavernosa of the penis, producing a painful fibrous chordee and penile curvature. Pfeiffer's disease infectious mononucleosis. Pick's disease 1. progressive atrophy of the cerebral convolutions in a limited area (lobe) of the brain, with clinical manifestations and course similar to Alzheimer's disease. polycystic kidney disease , polycystic disease of kidneys either of two unrelated heritable disorders marked by cysts in both kidneys: the autosomal dominant or adult form is more common, appears in adult life, and is marked by loss of renal function that can be either rapid or slow; the autosomal recessive or infantile form is more rare, may be congenital or may appear later in childhood, and almost always progresses to renal failure. polycystic renal disease polycystic kidney d.. Pompe's disease glycogen storage d., type II. Pott's disease spinal tuberculosis. primary electrical disease serious ventricular tachycardia, and sometimes ventricular fibrillation, in the absence of recognizable structural heart disease. prion disease any of a group of fatal, transmissible neurodegenerative diseases, which may be sporadic, familial, or acquired, caused by abnormalities of prion protein metabolism resulting from mutations in the prion protein gene or from infection with pathogenic forms of the protein. pulseless disease Takayasu's arteritis. Raynaud's disease a primary or idiopathic vascular disorder, most often affecting women, marked by bilateral attacks of Raynaud's phenomenon. Recklinghausen's disease 2. (of bone) osteitis fibrosa cystica generalisata. Refsum's disease an inherited disorder of lipid metabolism, characterized by accumulation of phytanic acid, chronic polyneuritis, retinitis pigmentosa, cerebellar ataxia, and persistent elevation of protein in cerebrospinal fluid. remnant removal disease familial dysbetalipoproteinemia. reversible obstructive airway disease a condition characterized by bronchospasm reversible by intervention, as in asthma. rheumatic heart disease the most important manifestation and sequel to rheumatic fever, consisting chiefly of valvular deformities. rheumatoid disease a systemic condition best known by its articular involvement (rheumatoid arthritis) but emphasizing nonarticular changes, e.g., pulmonary interstitial fibrosis, pleural effusion, and lung nodules. Ritter's disease dermatitis exfoliativa neonatorum. Roger's disease a ventricular septal defect; the term is usually restricted to small, asymptomatic defects. runt disease a graft-versus-host disease produced by immunologically competent cells in a foreign host that is unable to reject them, resulting in gross retardation of host development and in death. Salla disease an inherited disorder of sialic acid metabolism characterized by accumulation of sialic acid in lysosomes and excretion in the urine, mental retardation, delayed motor development, and ataxia. Sandhoff's disease a type of GM2 gangliosidosis resembling Tay-Sachs disease, seen in non-Jews, marked by a progressively more rapid course, and due to a defect in hexosaminidase, both isozymes A and B. Schamberg's disease a slowly progressive purpuric and pigmentary disease of the skin affecting chiefly the shins, ankles, and dorsa of the feet. Schilder's disease subacute or chronic leukoencephalopathy in children and adolescents, similar to adrenoleukodystrophy; massive destruction of the white substance of the cerebral hemispheres leads to blindness, deafness, bilateral spasticity, and mental deterioration. Schönlein's disease see under purpura. secondary disease 1. one subsequent to or as a consequence of another disease. 2. one due to introduction of incompatible, immunologically competent cells into a host rendered incapable of rejecting them by heavy exposure to ionizing radiation. self-limited disease one that runs a limited and definite course. serum disease see under sickness. severe combined immunodeficiency disease (SCID) see under immunodeficiency . sexually transmitted disease venereal disease; any of a diverse group of infections transmitted by sexual contact; in some this is the only important mode of transmission, and in others transmission by nonsexual means is possible. sickle cell disease any disease associated with the presence of hemoglobin S. Simmonds' disease see panhypopituitarism. sixth disease exanthema subitum. small airways disease chronic obstructive bronchitis with irreversible narrowing of the bronchioles and small bronchi. See also obstructive small airways d. Smith-Strang disease methionine malabsorption syndrome. Spielmeyer-Vogt disease Vogt-Spielmeyer d. Steinert's disease myotonic dystrophy. Still's disease juvenile rheumatoid arthritis. storage disease a metabolic disorder in which a specific substance (a lipid, a protein, etc.) accumulates in certain cells in unusually large amounts. storage pool disease a blood coagulation disorder due to failure of the platelets to release adenosine diphosphate (ADP) in response to aggregating agents; characterized by mild bleeding episodes, prolonged bleeding time, and reduced aggregation response to collagen or thrombin. Strümpell's disease 1. hereditary lateral sclerosis with the spasticity mainly limited to the legs. Strümpell-Leichtenstern disease hemorrhagic encephalitis. Strümpell-Marie disease ankylosing spondylitis. Sutton's disease 1. halo nevus. Swift's disease , Swift-Feer disease acrodynia. Takayasu's disease see under arteritis . Tangier disease a familial disorder characterized by a deficiency of high-density lipoproteins in the blood serum, with storage of cholesteryl esters in tissues. Tarui's disease glycogen storage d., type VII. Tay-Sachs disease (TSD) the most common GM2 gangliosidosis, seen almost exclusively in northeastern European Jews, characterized by infantile onset, doll-like facies, cherry-red macular spot, early blindness, hyperacusis, macrocephaly, seizures, hypotonia, and death in early childhood. Thomsen's disease myotonia congenita. thyrotoxic heart disease heart disease associated with hyperthyroidism, marked by atrial fibrillation, cardiac enlargement, and congestive heart failure. transmissible neurodegenerative disease prion d.. trophoblastic disease gestational trophoblastic neoplasia. tsutsugamushi disease scrub typhus. tunnel disease decompression sickness. uremic bone disease renal osteodystrophy. venereal disease sexually transmitted d. venoocclusive disease of the liver symptomatic occlusion of the small hepatic venules caused by ingestion of Senecio tea or related substances, by certain chemotherapy agents, or by radiation. vinyl chloride disease acro-osteolysis resulting from exposure to vinyl chloride, characterized by Raynaud's phenomenon and skin and bony changes on the limbs. Vogt-Spielmeyer disease the juvenile form of neuronal ceroid lipofuscinosis with onset between ages 5 and 10 years; characterized by rapid cerebroretinal degeneration, excessive neuronal storage of lipofuscin, and death within 10 to15 years. Volkmann's disease congenital deformity of the foot due to tibiotarsal dislocation. von Hippel's disease hemangiomatosis confined principally to the retina; when associated with hemangioblastoma of the cerebellum, it is known as von Hippel-Lindau d. von Hippel-Lindau disease a hereditary condition marked by hemangiomas of the retina and hemangioblastomas of the cerebellum, sometimes with similar lesions of the spinal cord and cysts of the viscera; there may be neurologic symptoms such as seizures and mental retardation. von Willebrand's disease an autosomal dominant bleeding disorder characterized by prolonged bleeding time, deficiency of von Willebrand's factor, and often impairment of adhesion of platelets on glass beads, associated with epistaxis and increased bleeding after trauma or surgery, menorrhagia, and postpartum bleeding. Waldenström's disease osteochondrosis of the capitular femoral epiphysis. Weber-Christian disease nodular nonsuppurative panniculitis. Werlhof's disease idiopathic thrombocytopenic purpura. Wernicke's disease see under encephalopathy. Westphal-Strümpell disease hepatolenticular degeneration. Whipple's disease a malabsorption syndrome marked by diarrhea, steatorrhea, skin pigmentation, arthralgia and arthritis, lymphadenopathy, central nervous system lesions, and infiltration of the intestinal mucosa with macrophages containing PAS-positive material. Whitmore's disease melioidosis. Wilson's disease an inherited, progressive disorder of copper metabolism, with accumulation of copper in liver, brain, kidney, cornea, and other tissues; it is characterized by cirrhosis in the liver, degenerative changes in the brain, and a pigmented ring at the outer margin of the cornea. Wolman's disease a lysosomal storage disease due to deficiency of the lysosomal sterol esterase, occurring in infants, and associated with hepatosplenomegaly, adrenal steatorrhea, calcification, abdominal distention, anemia, and inanition. woolsorter's disease inhalational anthrax. polycystic kidney disease (PKD), an abnormal condition in which the kidneys are enlarged and contain many cysts. There are three forms of the disease: Childhood polycystic disease is uncommon and may be differentiated from adult or congenital polycystic disease by genetic, morphologic, and clinical facets. Death usually occurs within a few years as the result of portal hypertension and liver and kidney failure. A portacaval shunt may prolong life into the twenties. Adult polycystic disease may be unilateral, bilateral, acquired, or congenital. The condition is characterized by flank pain and high blood pressure. Kidney failure eventually develops and progresses to uremia and death. Congenital polycystic disease is a rare congenital aplasia of the kidney involving all or only a small segment of one or both kidneys. Severe bilateral aplasia results in death shortly after birth. Minor aplasia may cause no dysfunction and may never be diagnosed. kidney either of the two organs in the lumbar region that filter the blood, excreting the end-products of body metabolism in the form of urine, and regulating the concentrations of hydrogen, sodium, potassium, phosphate and other ions in the extracellular fluid. Bean-shaped in the dog, cat, sheep and laboratory animals, lobed in the ox and some fetal animals such as the horse; irregularly lobed in birds. See also renal. artificial kidney an extracorporeal device used as a substitute for nonfunctioning kidneys to remove endogenous metabolites from the blood, or as an emergency measure to remove exogenous poisons such as barbiturates. Called also hemodialyzer. balloon kidney meat hygiene term for cystic kidney. basal lamina kidney part of the filtration barrier of the kidney; is much thicker than most basal laminae. cake kidney a solid, irregularly lobed organ of bizarre shape, formed by fusion of the two renal anlagen. Called also lump kidney. cicatricial kidney a shriveled, irregular and scarred kidney due to suppurative pyelonephritis. contracted kidney an atrophic kidney that may be scarred and granular. duplicate kidney occurs in most species, without apparent increase in total renal mass. enlarged kidney may be due to polycystic kidney disease, hydronephrosis, pyelonephritis or congenital absence of one kidney resulting in hypertrophy of the other. fatty kidney one affected with fatty degeneration. floating kidney one that is freely movable, especially a human kidney (normally more firmly fixed than those in quadrupeds); called also hypermobile kidney. See also nephroptosis. fused kidney a single anomalous organ developed as a result of fusion of the renal anlagen. giant kidney worm dioctophymerenale. Goldblatt kidney one with obstruction of its blood flow, resulting in renal hypertension. Produced experimentally in dogs. horseshoe kidney an anomalous organ resulting from fusion of the corresponding poles of the renal anlagen. hypermobile kidney one that is freely movable; called also floating kidney. See also nephroptosis. lump kidney cake kidney. kidney meridian points acupuncture points on the kidney meridian. pelvic kidney a kidney which has failed to ascend from its primordial site to the roof of the abdomen. polycystic kidney disease the most common congenital renal defect but most cases are sporadic and do not cause clinical illness because there is still sufficient renal mass to avoid uremia. In some cases the enlarged kidney is detected incidentally during a clinical examination. Rarely both kidneys are badly involved and the animal is dead at birth or dies soon afterwards. In some cases, there are signs of progressive renal failure, perhaps not until later in life. The defect is inherited in Persian cats, Cairn terriers and pigs. In Cairn terriers, cysts may also occur in the liver. See also feline perirenal cysts. pulpy kidney disease see Clostridium perfringensenterotoxemia. kidney scan radioimaging of a kidney by the use of a rectilinear scanner after the intravenous administration of a radiopaque material. kidney stones see urolithiasis. supernumerary kidney additional kidneys which develop as a consequence of two ureteric buds arising from one mesonephric duct so that two kidneys develop on the one side. kidney transplant commonly and successfully performed in experimental dogs. Increasingly used as a therapeutic procedure in clinical veterinary medicine for renal failure in cats and dogs. turkey egg kidney a speckled pattern caused by hemorrhagic glomeruli in diseases such as porcine erysipelas. wandering kidney floating or hypermobile kidney. See also nephroptosis. waxy kidney amyloid kidney. white-spotted kidney focal nonsuppurative interstitial nephritis, seen most commonly in calves. polycystic containing many cysts. polycystic kidney disease see polycystic kidney disease. polycystic liver congenital anomaly in which cystic remnants of the bile duct occur in the liver; the bile duct is patent; seen in kittens, pups, piglets. polycystic ovarian disease multiple thin-walled cysts in one or both ovaries of the mature bitch; may cause hyperestrogenism. polycystic pancreas cystic pancreatic and bile ducts and polycystic kidneys may occur in the same patient. polycystic renal disease see polycystic kidney disease. How to thank TFD for its existence? 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