103年:醫學二(2)

下列何種囊性腎病變( renal cystic disease )最常合併肝門脈區纖維化?

A兒童多囊性腎病( childhood polycystic kidney disease )
B成人多囊性腎病( adult polycystic kidney disease )
C成人腎髓質囊性病( adult-onset medullary cystic disease )
D後天性囊性腎病( acquired renal cystic disease )

詳細解析

本題觀念:

本題考查各種腎臟囊性疾病(renal cystic diseases)伴隨肝臟病變的特徵,核心是哪一種囊性腎病最常合併肝門脈區纖維化(hepatic portal fibrosis / congenital hepatic fibrosis)

選項分析

(A) 兒童多囊性腎病(childhood polycystic kidney disease)= 常染色體隱性遺傳多囊腎(autosomal recessive polycystic kidney disease, ARPKD)✅ 正確答案 ARPKD(PKHD1 基因突變,編碼 fibrocystin)是兒童最常見的遺傳性腎囊性疾病。其特徵之一是所有患者均伴有先天性肝纖維化(congenital hepatic fibrosis, CHF),表現為門脈區纖維化(portal fibrosis)、膽管板畸形(ductal plate malformation)。CHF 可導致門脈高壓(portal hypertension)、脾腫大(splenomegaly)及靜脈曲張出血。

(B) 成人多囊性腎病(adult polycystic kidney disease)= 常染色體顯性遺傳多囊腎(autosomal dominant polycystic kidn

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