Reviewer’ s report
Title: Type IV choledochal cyst with polycystic kidney disease:A case report
Version: 1Date: 21 Jun 2020
Reviewer's report:The presence of more than 3 renal cysts by ultrasound in the patient's daughter, who is 39 years
old (criteria in Pei et al, J Am Soc Nephrol, 2009), indeed allows the application to the patient of
at-risk (positive family history) criteria for the diagnosis of ADPKD. The MRI-based criteriaapplicable to at-risk individuals to establish the diagnosis of ADPKD (more than 10 renal cysts),however, is applicable to the age range of 16 to 40 years (Pei et al, J Am Soc Nephrol, 2015), andthe patient is 65 years old. Therefore, although the patient's MRI is highly suggestive of ADPKD,a conclusive diagnosis should be made/confirmed on the basis of one of the 3 choices below(which are very likely to be fulfilled in this patient):
1. A renal ultrasound with 4 or more cysts in each kidney (Pei et al, J Am Soc Nephrol, 2009).2. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 1 cm or more in each kidneywould be acceptable (since the Pei et al's ultrasound criteria were established with machines thatwere capable of detecting cysts with 1 cm or more in diameter). Obs.: This approach can also beused for CT imaging.
3. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 5 mm or more in each kidney
would be also acceptable (although with 1 cm or more would be more appropriate), since the Pei et
al's ultrasound criteria have been also applied to ultrasound imaging performed with new machinesthat detect cysts with 5 mm or more. Obs.: This approach can also be used for CT imaging.
Although not necessary for the current report (because the daughter already meets the diagnostic
criteria), a conclusive diagnosis of ADPKD can be also established/confirmed in the patient's sonusing one of the options above (but in this case 2 or more cysts in each kidney), since he is 42years old (therefore out of the 16-40-year range). Please include this information in the report.
Please also include more information in the discussion about the genetic and molecular basis of
ADPKD. The conclusion should be also written in a context that includes ADPKD, since it is itsassociation with type IV choledochal cyst what brings relevance to the manuscript.
Publons Reviewer Recognition. Springer Nature can send verification of this review directly to
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Yes
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests.Reviewer Publication Consent. I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the publishedreport have been included as confidential comments to the editor, which will not be published.Ifyou are not happy for us to publish this report, please contact the editorial office before completingthe review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
Reviewer’ s report
Title: Type IV choledochal cyst with polycystic kidney disease:A case report
Version: 1Date: 21 Jun 2020
Reviewer's report:The presence of more than 3 renal cysts by ultrasound in the patient's daughter, who is 39 years
old (criteria in Pei et al, J Am Soc Nephrol, 2009), indeed allows the application to the patient of
at-risk (positive family history) criteria for the diagnosis of ADPKD. The MRI-based criteriaapplicable to at-risk individuals to establish the diagnosis of ADPKD (more than 10 renal cysts),however, is applicable to the age range of 16 to 40 years (Pei et al, J Am Soc Nephrol, 2015), andthe patient is 65 years old. Therefore, although the patient's MRI is highly suggestive of ADPKD,a conclusive diagnosis should be made/confirmed on the basis of one of the 3 choices below(which are very likely to be fulfilled in this patient):
1. A renal ultrasound with 4 or more cysts in each kidney (Pei et al, J Am Soc Nephrol, 2009).2. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 1 cm or more in each kidneywould be acceptable (since the Pei et al's ultrasound criteria were established with machines thatwere capable of detecting cysts with 1 cm or more in diameter). Obs.: This approach can also beused for CT imaging.
3. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 5 mm or more in each kidney
would be also acceptable (although with 1 cm or more would be more appropriate), since the Pei et
al's ultrasound criteria have been also applied to ultrasound imaging performed with new machinesthat detect cysts with 5 mm or more. Obs.: This approach can also be used for CT imaging.
Although not necessary for the current report (because the daughter already meets the diagnostic
criteria), a conclusive diagnosis of ADPKD can be also established/confirmed in the patient's sonusing one of the options above (but in this case 2 or more cysts in each kidney), since he is 42years old (therefore out of the 16-40-year range). Please include this information in the report.
Please also include more information in the discussion about the genetic and molecular basis of
ADPKD. The conclusion should be also written in a context that includes ADPKD, since it is itsassociation with type IV choledochal cyst what brings relevance to the manuscript.
Publons Reviewer Recognition. Springer Nature can send verification of this review directly to
Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service,please click on the “Yes” option below. Your name, email address, title of the reviewed
manuscript, name of the journal, and date of your review submission (the “Review Data”) will
then be transmitted to Publons upon publication of the manuscript. If you have already registered
at Publons, they will notify you of the receipt of this review and update your profile as per your
settings and their policy. If you are not registered with Publons, you will receive an email fromthem asking you to register in order for them to be able to recognize your review on your newprofile page. Publons may use the Review Data to generate derivative metadata for the benefit ofPublons and you as a reviewer, carefully considering the sensitivity of such information. Forexample, Publons may verify your record as a reviewer by updating your profile published on itswebservice if you have registered for such service or help editors to identify candidate reviewers.Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms
Yes
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests.Reviewer Publication Consent. I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the publishedreport have been included as confidential comments to the editor, which will not be published.Ifyou are not happy for us to publish this report, please contact the editorial office before completingthe review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
Please review this paper.
user
Reviewer’ s report
Title: Type IV choledochal cyst with polycystic kidney disease:A case report
Version: 1Date: 21 Jun 2020
Reviewer's report:The presence of more than 3 renal cysts by ultrasound in the patient's daughter, who is 39 years
old (criteria in Pei et al, J Am Soc Nephrol, 2009), indeed allows the application to the patient of
at-risk (positive family history) criteria for the diagnosis of ADPKD. The MRI-based criteriaapplicable to at-risk individuals to establish the diagnosis of ADPKD (more than 10 renal cysts),however, is applicable to the age range of 16 to 40 years (Pei et al, J Am Soc Nephrol, 2015), andthe patient is 65 years old. Therefore, although the patient's MRI is highly suggestive of ADPKD,a conclusive diagnosis should be made/confirmed on the basis of one of the 3 choices below(which are very likely to be fulfilled in this patient):
1. A renal ultrasound with 4 or more cysts in each kidney (Pei et al, J Am Soc Nephrol, 2009).2. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 1 cm or more in each kidneywould be acceptable (since the Pei et al's ultrasound criteria were established with machines thatwere capable of detecting cysts with 1 cm or more in diameter). Obs.: This approach can also beused for CT imaging.
3. If not possible to have an ultrasound: Although not validated by a performed study, some
experts would consider that a renal MRI with 4 or more cysts with 5 mm or more in each kidney
would be also acceptable (although with 1 cm or more would be more appropriate), since the Pei et
al's ultrasound criteria have been also applied to ultrasound imaging performed with new machinesthat detect cysts with 5 mm or more. Obs.: This approach can also be used for CT imaging.
Although not necessary for the current report (because the daughter already meets the diagnostic
criteria), a conclusive diagnosis of ADPKD can be also established/confirmed in the patient's sonusing one of the options above (but in this case 2 or more cysts in each kidney), since he is 42years old (therefore out of the 16-40-year range). Please include this information in the report.
Please also include more information in the discussion about the genetic and molecular basis of
ADPKD. The conclusion should be also written in a context that includes ADPKD, since it is itsassociation with type IV choledochal cyst what brings relevance to the manuscript.
Publons Reviewer Recognition. Springer Nature can send verification of this review directly to
Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service,please click on the “Yes” option below. Your name, email address, title of the reviewed
manuscript, name of the journal, and date of your review submission (the “Review Data”) will
then be transmitted to Publons upon publication of the manuscript. If you have already registered
at Publons, they will notify you of the receipt of this review and update your profile as per your
settings and their policy. If you are not registered with Publons, you will receive an email fromthem asking you to register in order for them to be able to recognize your review on your newprofile page. Publons may use the Review Data to generate derivative metadata for the benefit ofPublons and you as a reviewer, carefully considering the sensitivity of such information. Forexample, Publons may verify your record as a reviewer by updating your profile published on itswebservice if you have registered for such service or help editors to identify candidate reviewers.Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms
Yes
Are the methods appropriate and well described?
If not, please specify what is required in your comments to the authors.
YesDoes the work include the necessary controls?
If not, please specify which controls are required in your comments to the authors.
YesAre the conclusions drawn adequately supported by the data shown?
If not, please explain in your comments to the authors.
YesAre you able to assess any statistics in the manuscript or would you recommend an
additional statistical review?
If an additional statistical review is recommended, please specify what aspects require furtherassessment in your comments to the editors.
Not relevant to this manuscriptQuality of written English
Please indicate the quality of language in the manuscript:
AcceptableDeclaration of competing interests
Please complete a declaration of competing interests, considering the following questions:
1. Have you in the past five years received reimbursements, fees, funding, or salary from an
organisation that may in any way gain or lose financially from the publication of thismanuscript, either now or in the future?
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose
financially from the publication of this manuscript, either now or in the future?
3. Do you hold or are you currently applying for any patents relating to the content of the
manuscript?
4. Have you received reimbursements, fees, funding, or salary from an organization that holds
or has applied for patents relating to the content of the manuscript?
5. Do you have any other financial competing interests?
6. Do you have any non-financial competing interests in relation to this paper?
If you can answer no to all of the above, write 'I declare that I have no competing interests' below.
If your reply is yes to any, please give details below.
I declare that I have no competing interests.Reviewer Publication Consent. I agree for my report to be made available under an Open Access
Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manu-script is accepted for publication. Any comments that I do not wish to be included in the publishedreport have been included as confidential comments to the editor, which will not be published.Ifyou are not happy for us to publish this report, please contact the editorial office before completingthe review.If you wish, you can include your name in your published report. Please note you mustdecide whether to include your name at the start of the process and confirm this decision wheneverprompted. If you change your decision later, we will not be able to publish your name.
I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report.
(default)
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