A 61-year-old female kidney transplant recipient pre-sented with acute abdominal pain and chills. She was di-agnosed with autosomal dominant polycystic kidney disease (ADPKD) at the age of 35 and had suffered from several renal cyst haemorrhages. She had been success-fully transplanted with a kidney from a deceased donor 1 month earlier, after spending 5 months on haemodialysis; a right nephrectomy was performed along with the trans-plantation. Immunosuppressive regimen included tacroli-mus, mycophenolate mofetil and steroids. The post-operative period was uncomplicated with a prompt fall of serum creatinine to 1.5 mg/dL (132 μmol/L). On clinical examination, temperature was 37.1°C, and the abdomen was slightly painful in the periumbilical area. C-reactive protein was 10.5 mg/dL, and urine analysis was normal
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