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$Unique_ID{BRK04119}
$Pretitle{}
$Title{Polycystic Liver Disease}
$Subject{Polycystic Liver Disease PLD PCLD Solitary Cysts Caroli Syndrome
Echinococcal Cysts Neoplastic Cysts}
$Volume{}
$Log{}
Copyright (C) 1989, 1990 National Organization for Rare Disorders, Inc.
665:
Polycystic Liver Disease
** IMPORTANT **
It is possible that the main title of the article (Polycystic Liver
Disease) is not the name you expected. Please check the SYNONYM listing to
find the alternate names and disorder subdivisions covered by this article.
Synonyms
PLD
PCLD
Information on the following diseases can be found in the Related
Disorders section of this report:
Solitary Cysts
Caroli Syndrome
Echinococcal Cysts
Neoplastic Cysts
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Polycystic Liver Disease (PLD) is an inherited disorder characterized by
many cysts in the liver. Abdominal discomfort from swelling of the liver may
occur; however, most patients do not have any symptoms.
Symptoms
Polycystic Liver Disease is characterized by a few to many cysts in the liver
ranging from a few millimeters to over 15 cm in diameter. Symptoms rarely
occur although the liver gradually enlarges as it is replaced by cysts.
Abdominal discomfort may occur due to the stretching of the liver. Fever may
also occur if the cysts break due to infection or bleeding into a cyst.
Rarely, yellowing of the skin (jaundice) may occur if the bile ducts are
compressed by a cyst. High blood pressure in the portal system (blood flow
from the intestines to the liver) occurs only if the portal vein is
compressed by a cyst.
Liver function is generally unaffected if the liver has only a few cysts
or small cysts.
Fifty percent of PLD patients have cysts in their kidneys. Rarely, cyst-
like lesions can occur in the pancreas, lungs, spleen, and other organs.
Causes
Polycystic Liver Disease is inherited as an autosomal dominant trait. Liver
cysts may also occur as a result of abnormally developed bile ducts in the
fetus.
Human traits including the classic genetic diseases, are the product of
the interaction of two genes for that condition, one received from the father
and one from the mother. In dominant disorders a single copy of the disease
gene (received from either the mother or father) will be expressed
"dominating" the other normal gene and resulting in appearance of the
disease. The risk of transmitting the disorder from affected parent to
offspring is fifty percent for each pregnancy regardless of the sex of the
resulting child.
Affected Population
Polycystic Liver Disease (PLD) affects males and females in equal numbers.
PLD may occur at any age; however, cysts are less common during childhood.
Related Disorders
Symptoms of the following disorders can be similar to those of Polycystic
Liver Disease. Comparisons may be useful for a differential diagnosis:
Solitary cysts of the liver are most often present in the right part of
the liver. They may contain a few milliliters or more than a liter of fluid.
Most cysts cause no symptoms. Among patients that do have symptoms, the most
common are abdominal discomfort, nausea, and vomiting.
Caroli Syndrome is a rare congenital liver disorder characterized by
enlargement (dilation) of the bile ducts inside the liver. If symptoms
occur, the most common are abdominal pain, fever, and yellowing of the skin
(jaundice). Caroli Syndrome occurs because of abnormal prenatal development.
(For more information on this disorder, choose "Caroli" as your search term
in the Rare Disease Database).
The parasitic tapeworm Echinococcus may cause cysts in the liver. It is
more common in central and eastern Europe and rare in the United States. The
cyst of Echinococcus granulosus is usually solitary, located in the right
part of the liver, and causes no symptoms. Echinococcus multilocularis may
cause many cysts in the liver and may extend beyond it. A few patients may
have abdominal pain or a slight swelling. Rupture of a cyst, infection, or
an allergic reaction may occur as complications.
Neoplastic cysts are called tumors which are abnormal tissue growths.
There are two kinds: benign or malignant. Benign tumors may cause abdominal
discomfort or bleeding within the sac that lines the abdominal cavity
(peritoneum). Liver function is usually normal with benign tumors.
Malignant tumors may cause loss of appetite, weight loss, pain, and fever.
The liver may be enlarged, tender, and hard. Excess watery fluid in the
spaces between the tissues and organs in the abdomen (ascites) may also
occur. Yellowing of the skin (jaundice) is usually absent or mild but may
worsen with time.
Therapies: Standard
Imaging machines such as Angiography, Magnetic Resonance Imaging (MRI),
Computed Tomography (CT) Scan, and Ultrasound (US) can take pictures of the
liver to see if cysts are present.
No treatment may be necessary in many cases of Polycystic Liver Disease
(PLD).
Removal of the fluid in large cysts (aspiration) may be required in PLD
patients with troublesome symptoms.
Genetic counseling may be of benefit for patients and their families.
Other treatment is symptomatic and supportive.
Therapies: Investigational
Researchers are investigating several types of surgery that may be effective
to treating large troublesome cysts in Polycystic Liver Disease. Unroofing,
Fenestration, and Hepatectomy are being studied. Unroofing involves removing
the membrane of the cyst and may also involve draining the fluid from the
cyst. Fenestration involves creating an opening in the cyst and may also
involve removing the cyst. Hepatectomy is the removal of part of the liver.
This procedure is used for the most severe cases of Polycystic Liver Disease.
Rarely, surgical intervention may be needed to treat portal high blood
pressure when it occurs as a rare complication in Polycystic Liver Disease.
This disease entry is based upon medical information available through
January 1990. Since NORD's resources are limited, it is not possible to keep
every entry in the Rare Disease Database completely current and accurate.
Please check with the agencies listed in the Resources section for the most
current information about this disorder.
Resources
For more information on Polycystic Disease, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
American Liver Foundation
1425 Pompton Ave.
Cedar Grove, N.J. 07009
(201) 857-2626
(800) 223-0179
The United Liver Foundation
11646 West Pico Blvd.
Los Angeles, CA 90064
(213) 445-4204 or 445-4200
The United Liver Foundation
11646 West Pico Blvd.
Los Angeles, CA 90064
(213) 445-4204 or 445-4200
Children's Liver Foundation
14245 Ventura Blvd.
Sherman Oaks, CA 91423
(818) 906-3021
For genetic information and genetic counseling referrals:
March of Dimes Birth Defects Foundation
1275 Mamaroneck Avenue
White Plains, NY 10605
(914) 428-7100
Alliance of Genetic Support Groups
35 Wisconsin Circle, Suite 440
Chevy Chase, MD 20815
(800) 336-GENE
(301) 652-5553
References
MENDELIAN INHERITANCE IN MAN, 7th ed.: Victor A. McKusick; Johns Hopkins
University Press, 1986. Pp. 608.
INTERNAL MEDICINE, 2nd Ed.: Jay H. Stein, ed.-in-chief; Little, Brown
and Co., 1987. Pp. 241.
THERAPEUTIC DILEMMAS IN PATIENTS WITH SYMPTOMATIC POLYCYSTIC LIVER
DISEASE: R.H. Turnage, et al.; Am Surg (June, 1988: issue 54(6)). Pp. 365-
372.
MASSIVE HEPATOMEGALY IN ADULT POLYCYSTIC LIVER DISEASE: M.K. Kwok & K.J.
Lewin; Am J Surg Pathol (April, 1988: issue 12(4)). Pp. 321-324.