Nickan Research Institute Journal of Renal Injury Prevention 2345-2781 5 1 2016 03 01 Pleuritic chest pain from portal hypertensive gastropathy in ESRD patient with autosomal dominant polycystic kidney disease misdiagnosed as pericarditis. 48 52 10.15171/jrip.2016.11 EN Macaulay Amechi Chukwukadibia Macaulay Amechi Chukwukadibia Onuigbo Nneoma Agbasi Jennifer Achebe Charles Odenigbo Fidelis Oguejiofor Journal Article 10.15171/jrip.2016.11 Chest pain in ESRD from ADPKD has a list of differential diagnosis which includes uremic pericarditis, acute coronary artery disease, pericardial effusion and rarely pericardial cysts, among others. We present a case of pleuritic chest pain secondary to portal hypertensive gastropathy (PHG) in a 24-year old Caucasian male patient with ADPKD who was on maintenance hemodialysis for ESRD, and who previously had been misdiagnosed as acute recurrent pericarditis. The management options for PHG are briefly discussed. Finally, we propose that PHG should be kept in the differential diagnosis of chest pain, pleuritic or non-pleuritic, with or without gastrointestinal symptoms, in patients with ADPKD, with or without renal failure. Moreover, the importance of a detailed medical history in the management of these patients cannot be over emphasized.