What extrarenal manifestations are common in autosomal dominant polycystic kidney disease (ADPKD)?

• A. Pancreatic cysts.
• B. Hepatic cysts and berry aneurysms in the circle of Willis.
• C. Hypertension only.
• D. Splenomegaly.

Answer: (B)

ADPKD isn’t limited to the kidneys; the disease commonly involves other organs as cysts form in wider tissues. The classic outside-the-kidneys findings are hepatic cysts and berry aneurysms in the circle of Willis. Liver cysts are a frequent extrarenal manifestation and are often asymptomatic, though they can cause discomfort if they enlarge. Berry aneurysms reflect vascular involvement and carry the risk of rupture, leading to subarachnoid hemorrhage, which is a major clinical concern in these patients. Hypertension is indeed common in ADPKD, but it mainly arises from the kidney disease itself, not as an extrarenal manifestation. Splenomegaly and pancreatic cysts are not defining features. So, hepatic cysts together with berry aneurysms best represent the extrarenal manifestations associated with ADPKD.