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PubMed1988

Development of fatal bilateral xanthogranulomatous pyelonephritis in a paraplegic patient: case report.

The first case of a bilateral xanthogranulomatous pyelonephritis (XGPN) is reported in a paraplegic patient who did not practise intermittent catheterisation after discharge from the hospital but resorted to the Crede manoeuvre which predisposed to a fatal urinary tract infection and development of XGPN over a period of 5 weeks. The advantages of clean, unsterile, intermittent self catheterisation over the Crede manoeuvre in patients with a neuropathic bladder are discussed especially in preventing infective complications of the upper urinary tract which may prove life threatening as occurred in this patient.

Adult↗
PubMed1991

[The place of diagnostic imaging in xanthogranulomatous pyelonephritis].

The urographic, angiographic, sonographic and computed tomographic findings in 4 cases of xanthogranulomatous pyelonephritis are presented along with correlation with the pathological specimens. The parenchyma of the kidney was replaced by multiple, rounded, low-density respectively hypoechogenic areas on CT and sonography that corresponded to dilated calices and/or inflammatory tissue. For diagnosing the characteristic extrarenal extension of the disease sonography was not as accurate as CT.

Adult↗
PubMedDate not supplied

[Xanthogranulomatous pyelonephritis. Our experience in the last 10 years].

A retrospective study of 34 xanthogranulomatous pyelonephritis (XGP) cases operated on in our Service was performed. An analysis is made of the clinical signs, laboratory data, imaging diagnostic techniques and the value of cytology in the assessment of this entity. A very characteristic clinical and biological picture, although somewhat nonspecific of XGP, was encountered. The high sensitivity of simple abdominal X-ray films and I.V.U., as well as the high specificity of cytologic studies in the diagnosis of the disease, was shown.

Adult↗
PubMed1997

Focal xanthogranulomatous pyelonephritis: partial nephrectomy as definitive treatment.

OBJECTIVES: We report 11 cases of focal xanthogranulomatous pyelonephritis (FXGP), a disease that is very uncommon. The aim of the present work is to assess the effectivity of conservative treatment. MATERIAL AND METHODS: Eleven of the 82 cases of XGP (12.5%) diagnosed between 1970 and 1995 presented the focal form (FXGF). Clinical features, laboratory findings, radiological imaging studies, surgical treatment and follow-up were evaluated. RESULTS: FXGP occurred in middle-aged women (female/male ratio 4.5:1) who had a history of calculosis, urinary infections produced by Escherichia coli and Proteus mirabilis, or urinary tract abnormalities. FXGP was unilateral in all cases. The most frequent symptom was flank pain. Some hematological and biochemical parameters were altered. Intravenous urography and sonography revealed calculosis, hydronephrosis or renal mass, but these findings are nonspecific. Only abdominal CT scan can establish the correct diagnosis. Five of these patients (45.5%) underwent partial nephrectomy at our hospital. During the follow-up, patients showed no relapse in the ipsilateral or contralateral kidney. Serum parameters were in normal range. CONCLUSION: When FXGP is diagnosed, local excision is recommended in all cases, since relapse in the affected kidney is unusual.

Adult↗
PubMed2002

[Renal stone ileus in xanthogranulomatous pyelonephritis. A case report].

A peculiar case of intestinal occlusion caused by a renal stone in a patient with nephroduodenal fistula due to previous xanthogranulomatous pyelonephritis is reported. Only few cases of nephroduodenal fistula are described in the literature, generally as a single case report or in small series. A nephroduodenal fistula as a result of chronic renal inflammatory disease such as xanthogranulomatous pyelonephritis, is usually associated with renal stones, recurrent urinary tract infections or endocrine disorders. Finally, renal stone as a cause of ileus is an event rarely described in the literature. In the case described, a correct preoperative diagnosis was possible with computerized tomography. During the operation a big renal stone was found and removed from the small bowel, but a limited resection was necessary because of the vascular impairment of the tract. At 8-month follow-up from operation, the patient was in good health, and no symptoms of renal or intestinal diseases were found.

Acute Kidney Injury↗
PubMed1986

Bilateral metachronous xanthogranulomatous pyelonephritis in end-stage renal failure.

We report a case of bilateral metachronous xanthogranulomatous pyelonephritis (XGP) in a hemodialyzed patient with end-stage renal failure due to bilateral nephrolithiasis. The XGP was initially diagnosed by computed tomographic (CT) scan, and right nephrectomy was performed. The patient remained clinically stable for the next year. Involvement of the contralateral kidney was again confirmed by CT examination. Both kidneys showed histologic changes compatible with XGP. A coexisting nephrogenic adenoma of the bladder has been attributed to chronic urinary tract infection.

Female↗
PubMed2000

Xanthogranulomatous pyelonephritis presenting as a pseudotumor in a 2-month-old boy.

The authors report on a 2-month-old boy presenting with a right renal mass. Investigations including ultrasound scan and computed tomogram were suggestive of a renal tumor. A right nephrectomy was performed with great difficulty because of dense adhesions to the adjacent structures. Cut section of the specimen showed the entire kidney to be replaced by cheesy-yellow areas. Histological examination was suggestive of xanthogranulomatous pyelonephritis. Although rare at this age, xanthogranulomatous pyelonephritis should be considered in the differential diagnosis of a renal mass in children. The lesion is unique among the inflammatory conditions in closely mimicking renal tumours clinically. A thorough histological examination also is suggested because the features can get confused easily with those of renal tumors.

Diagnosis, Differential↗
PubMed2001

Sonographic features of xanthogranulomatous pyelonephritis.

PURPOSE: The purpose of this study was to describe the various sonographic features of xanthogranulomatous pyelonephritis (XGP). METHODS: We retrospectively reviewed the CT, sonographic, and medical records of patients diagnosed with XGP from January 1981 to December 1998. Twenty-seven patients for whom XGP was histopathologically confirmed were included in the study. There were 12 men and 15 women, with an age range of 21-86 years (mean, 57 years). All patients had undergone sonography of the kidneys. The renal size, shape, and outline were recorded. The presence of perinephric fluid accumulation, of obstructive uropathy, or of internal echoes in the dilated collecting system and the echotexture of the renal parenchyma were documented. RESULTS: We categorized the XGP into 4 groups on the basis of the sonographic features: (1) diffuse hydronephrotic, 12 patients (44%); (2) diffuse parenchymal, 9 patients (33%); (3) diffuse contracted, 4 patients (15%); and (4) segmental or focal, 2 patients (7%). A localized perinephric fluid collection was present in 4 patients (15%). The preoperative sonographic diagnoses were pyonephrosis (n = 14, 52%), renal pelvic tumor with possible associated infection (n = 5, 19%), renal parenchymal mass (n = 2, 7%), hydronephrosis (n = 2, 7%), and chronic pyelonephritis with renal atrophy (n = 4, 15%). XGP was considered a possible diagnosis in only 11 patients (41%). CONCLUSIONS: XGP has no specific sonographic features but is suggested by parenchymal thinning and hydronephrosis, sonographic signs of chronic obstructive uropathy caused by stones; echoes in the dilated collecting system; and a perinephric fluid collection. CT, needle biopsy, or both are recommended to further evaluate and confirm sonographically suspected XGP.

Adult↗
PubMed1990

[Xanthogranulomatous pyelonephritis in infancy and childhood. Report of two cases].

We are reporting 2 cases of xanthogranulomatous pyelonephritis in boys of 7 and 2 year-old. The inflammatory lesion had extended to perirenal tissues and appeared as a lumbar abscess in case 1. The kidneys affected were diffusely compromised by the lesion. Both cases showed Proteus mirabilis after microbiologic cultures. Definitive diagnosis was done by pathology examination. Nephrectomy was curative.

Abscess↗
PubMed1990

[Xanthogranulomatous pyelonephritis in children. Apropos of 8 cases].

Eight pediatric cases of the diffuse form of xanthogranulomatous pyelonephritis are reported. These patients were selected among 17 with destruction of one kidney. Clinical symptoms were suggestive of a tumor in some instances. However, an infectious etiology was strongly suggested by the presence of a renal lithiasis in seven cases (including five staghorn stones) and of a urinary tract infection in six cases (usually caused by a Proteus). Nephrectomy was performed in every case.

Child↗
PubMed2006

Xanthogranulomatous pyelonephritis with a renocolic fistula caused by a parapelvic cyst.

Fistula formation between the upper urinary tract and bowel is an uncommon complication in urogenital diseases. We present a rare case of focal xanthogranulomatous pyelonephritis with a renocolic fistula. This is the first case where a parapelvic cyst obstructs the caliceal outflow and leads to the formation of a renocolic fistula in renal inflammatory disease. It is difficult to make a preoperative diagnosis of focal xanthogranulomatous pyelonephritis with widespread involvement that is caused by non-calculous urinary tract obstruction.

Colonic Diseases↗
PubMed2006

Xanthogranulomatous pyelonephritis: Analysis of 18 cases.

OBJECTIVE: To review and evaluate patients with a clinicopathological diagnosis of xanthogranulomatous pyelonephritis (XGP) with emphasis on the diagnostic methods and the effect of socioeconomic status on disease severity. METHODS: Data compiled from the previous history of the patients, clinical, laboratory, radioimaging findings, preoperative, operative, histopathological diagnosis and postoperative follow-up period were analysed. On the basis of presentation, XGP was classified as complicated and simple. RESULTS: There were 18 cases of XGP. The clinical characteristics included: calculi or obstruction in the urinary tract, and damage to the kidney, complication of urinary tract infection, anaemia, increased erythrocyte sedimentation rate and liver dysfunction. All patients had diffuse XGP. Associated pathological findings such as psoas abscess, nephrocutaneous fistula, renocolonic fistula and paranephric abscess were found in 33.3% of cases. Eleven of 14 patients (78.6%) who were evaluated by computed tomography (CT) had the correct diagnosis made prior to nephrectomy. Urine culture was positive in 88.9% of patients and Proteus mirabilis was the most common organism. CONCLUSION: Our experience with a small number of patients demonstrates that low socioeconomic status could be a risk factor in the development of complicated cases of XGP. CT is considered to be the best radiological test for correct preoperative diagnosis and evaluation of XGP. Nephrectomy and removal of all surrounding affected tissue proved to be curative for XGP.

Adolescent↗
PubMed1986

Xanthogranulomatous pyelonephritis: clinical experience with 62 cases.

A review of 62 patients who underwent surgical treatment for xanthogranulomatous pyelonephritis is presented. Polar resection was performed in 3 cases with localized disease, while the remaining 59 patients were treated by nephrectomy. Preoperative diagnosis is still tentative, but the recent advances in imaging techniques and urinary cytology will provide greater accuracy in the future.

Adolescent↗
PubMed1991

Xanthogranulomatous pyelonephritis, perinephric type--a case report.

A 46 year-old woman with perinephric type of xanthogranulomatous pyelonephritis is described. She had a fever and pain with a palpable mass in her right flank. The blood analysis revealed anemia, leucocytosis, gamma-globulinemia, but no hyperlipidemia. The urine analysis showed nothing abnormal, but enterobacter was present in the urine. An intravenous pyelogram demonstrated a right non-functioning kidney. The diagnosis of a perinephric abscess was made from the x-ray and ultrasonogram, and a right nephrectomy was performed. The resected kidney had a tumor-like lump covered with Gerota's fascia at the postero-lateral side of the kidney. The cut surface of the kidney revealed an area of hemorrhage, blood clotting, abscess and a brownish yellow area in the perinephric fat tissue. The calyx and pelvis were normal. Histologically, the brownish yellow area was a granuloma with foam cell infiltration. The foam cells contained lipids. The renal parenchyma showed a non-specific chronic pyelonephritis.

Female↗
PubMed2000

[Xanthogranulomatous pyelonephritis presenting as a Grawitz tumor in a 21-year-old female patient. Case report] ].

Xanthogranulomatous pyelonephritis is a chronic inflammatory disease of the kidney characterized by destruction and replacement of the renal parenchyma with granulomatous tissue containing lipid-filled macrophages. The disease affects mainly elders, more frequent females and is difficult to differentiate it from renal neoplasms by standard diagnostic imaging methods. This case report confirms it.

Adult↗
PubMed1991

[Xanthogranulomatous pyelonephritis. Apropos of 42 cases].

The authors report their experience of forty-two cases of xanthogranulomatous pyelonephritis. They point out the various difficulties of preoperative identification of such diseases by the imaging modalities. They also discuss the main pathogenic hypotheses proposed in the literature.

Adolescent↗
PubMed1989

Xanthogranulomatous pyelonephritis--(a clinicopathological study of 15 cases)

The clinico-pathological features of 15 patients with xanthogranulomatous pyelonephritis (XGP) are described and the probable histogenesis is discussed. Based on our data and the review of literature, we believe that XGP should be regarded as a destructive and at times tumefactive inflammatory process that may complicate chronic pyelonephritis. The initiation of this process remains obscure, but the features commonly associated with XGP are pelvi-calyceal obstruction, ulceration of the pelvic urothelium with collection of necrotic material and bacterial infection.

Adult↗