Citations

ABSTRACT Histoplasmosis has a wide spectrum of presentations ranging from mild pulmonary disease to a more widespread infection leading to disseminated histoplasmosis. Gastrointestinal histoplasmosis is a rare form of disseminated histoplasmosis that most commonly causes nonspecific symptoms and rarely presents with serious symptoms. Duodenal involvement is further rare but can cause ulcerated lesions leading to upper gastrointestinal bleed. The potential for a nonspecific initial presentation quickly progressing to a fatal upper gastrointestinal bleed makes it important to keep Gastrointestinal histoplasmosis in our list of differentials, as timely initiation of appropriate antifungal therapy can significantly reduce the risk of severe complications and mortality.

Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is one of the most prevalent heritable disorders, characterized by the progressive development of kidney cysts leading to renal failure. It is primarily caused by mutations in the PKD1 and PKD2 genes, which account for approximately 85% and 15% of cases, respectively. This case report describes a previously unreported mutation in the PKD1 gene, identified in a family involving an aunt and her niece with ADPKD. Case Presentation: The index case, a 56-year-old female with chronic kidney disease stage 3b secondary to ADPKD and hypertension, exhibited a strong family history of polycystic kidney disease (PKD). Initial genetic evaluations did not identify any recognized pathogenic mutations, leading to a more detailed investigation which revealed a novel mutation in the PKD1 gene. This mutation was also found in her niece, who presented with early-onset disease. Conclusions: The identification of a heterozygous six-nucleotide deletion, c.2084_2089del, resulting in the in-frame deletion of two amino acids, p.Pro695_Ala696del, in the PKD1 gene, has been linked with ADPKD in these patients. This report emphasizes the need for continuous updates to genetic data for a deeper understanding of the diagnosis and prognosis of ADPKD that could potentially aid in targeted therapy.