Xanthogranulomatous pyelonephritis.
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Granuloma↗
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Xanthogranulomatous pyelonephritis and amyloidosis: a rare association.
The coincidence of systemic amyloidosis and xanthogranulomatous pyelonephritis has been reported previously only once. Clinical findings, such as the nephrotic syndrome, cardiac and autonomic nervous system dysfunction, and adrenal insufficiency, are suggestive and a thorough investigation to rule out other causes of secondary amyloidosis is warranted. We report a case of xanthogranulomatous pyelonephritis associated with secondary systemic amyloidosis and the nephrotic syndrome. Treatment consisted of nephrectomy and intensive supportive care. The unique clinical, radiographic and pathological aspects of this case are discussed.
Amyloidosis↗
[Xanthogranulomatous pyelonephritis. Radiological and ultrasonographic aspects].
Clinical, radiological and ultrasonographical features of three cases of xanthogranulomatous pyelonephritis, one of which in a child, are reported. Presurgical diagnosis of xanthogranulomatous pyelonephritis is difficult and infrequent to date (10-14% of cases according to different workers). This complaint is generally mistaken for other types of kidney infections or tumours. The use of ultrasonography and computed tomography in particular help recognition of the disease and above all help to assess its extra-renal spread: something that has only recently been made possible.
Adult↗
Xanthogranulomatous pyelonephritis: a critical analysis of 26 cases and of the literature.
Manifestations of xanthogranulomatous pyelonephritis in 26 patients closely mimicked those of neoplastic and other inflammatory renal parenchymal diseases. Middle-aged or older women were affected most often. Most patients presented with anemia, chronic febrile illness, a painful tender flank mass and recurrent urosepsis. Some features of nephrogenic hepatic dysfunction were present in 13 patients. Bacterial cultures of renal tissue were almost always positive but the spectrum differed considerably from that of the bladder urine. Urographically, a renal mass lesion was encountered in 62% of the patients, nephrolithiasis in 38% and a functionless kidney in 27%. Angiographically, none of the 4 mass lesions studied was distinguished from hypernephroma. Indeed, a correct preoperative diagnosis was made in only 1 instance. There were 3 stages of xanthogranulomatous pyelonephritis recognized. Treatment consisted of nephrectomy for diffuse or advanced stage disease or both (21 patients), excision of the diseased renal segment for localized and low stage disease (2 patients) and renal biopsy (3 patients). Xanthogranulomatous pyelonephritis did not recur but in some patients bacteriuria continued or hypertension developed.
Adolescent↗
[Unusual clinical forms of presentation and infrequent pathologic associations of xanthogranulomatous pyelonephritis].
OBJECTIVE: To describe the unusual clinical forms and rare associations of xanthogranulomatous pyelonephritis seen in a variable proportion of cases. METHODS: Analysis of our series of 83 cases and 2573 cases reported in the literature showed 8 different and less frequent clinical forms and up to 7 rare associations, which are discussed in this study. RESULTS: There are different clinical forms under "renal infection", ranging widely from asymptomatic to severe septic forms that affect patients of all ages--from the newborn to the elderly-, preferentially in association with conditions of immunosuppression, and other more uncommon or rare forms in which xanthogranulomatous pyelonephritis is often incidentally discovered. CONCLUSIONS: These forms are not extremely rare since more than 2500 cases have been reported in the literature. Knowledge about the different forms permits stratification of this condition into different clinical forms of presentation and provides further insight into the associated conditions, some of which are rare. Overall, such forms or associations have been reported to account for 20 to 40% of all cases, according to the studies reported elsewhere. This overall incidence is rather significant and should be taken into account.
Humans↗
A case of xanthogranulomatous pyelonephritis in a child.
We report an additional case of histopathologically confirmed xanthogranulomatous pyelonephritis in a 9-year-old boy. He was admitted to hospital with a two-day history of sustained fever. Physical examination revealed tenderness in the right upper quadrant of the abdomen. Results of a complete blood count and serum biochemical investigations showed slight anemia and positive C reactive protein. Culture of urine failed to grow any bacteria. Excretory urography revealed deformity of the right renal calyces. Computed tomography showed a focal area of low density in the right kidney. Nephrectomy was carried out as fever had been sustained despite intensive treatment with antibiotics. Sectioning revealed that the renal parenchyma had been replaced by a butter yellow nodule, which was histopathologically confirmed as xanthogranulomatous pyelonephritis. This is the nineteenth reported case in children in Japan to our knowledge.
Adolescent↗
Xanthogranulomatous pyelonephritis: our experience with review of published reports.
BACKGROUND: The aim of this study was to analyse the cases of xanthogranulomatous pyelonephritis with review of published reports. METHODS: We retrospectively reviewed all nephrectomy specimens during February 1995 to January 2006. We found 26 cases of xanthogranulomatous pyelonephritis. We prepared a chart of these cases consisting of preoperative symptoms, laboratory findings, radiological imaging results and preoperative diagnosis. Open nephrectomy was carried out in all cases. RESULTS: Age group of the patients was 6-65 years and male : female ratio was 1.6:1. Twenty-two patients presented to us with intermittent high-grade fever, 21 with flank pain, 18 with loin mass, 2 with haematuria and 1 was detected during screening of vague gastrointestinal symptoms. Twenty-five patients had pyuria and only 10 had sterile urine culture. In all patients, only one kidney was affected. All patients had renal calculi 10-42 mm in size with bilaterally enlarged kidneys. Ipsilateral kidney was enlarged because of hydronephrosis or pyonephrosis in all cases and contralateral kidney was enlarged because of compensatory hypertrophy in 13 cases. Ipsilateral kidney had severely compromised renal function in all cases. Associated psoas abscess was present in one and tuberculosis in another. CONCLUSION: Xanthogranulomatous pyelonephritis is a relatively rare entity that is associated with obstruction, stones and infection of the urinary tract. Late presentation leads to loss of renal parenchyma. It cannot be differentiated preoperatively with renal tumours (renal cell carcinoma and Wilms' tumour), pyonephrosis, infected hydronephrosis and renal lymphoma. Nephrectomy and antibiotics are the treatment of choice.
Adolescent↗
Xanthogranulomatous pyelonephritis masquerading as occult malignancy.
Xanthogranulomatous pyelonephritis (XGP) can present with weight loss, anemia, leukemoid reaction, and generalized debility; there may be no signs or symptoms referable to the urinary tract. Confusion between XGP and renal adenocarcinoma is well recognized, but other malignancies can also be simulated. Case histories of patients with proved XGP whose clinical presentations suggested occult malignancies are recorded. Proteus urinary tract infection, calculi, and a nonvisualizing kidney on intravenous pyelogram should suggest the correct diagnosis. The pathology, bacteriology, diagnosis, and treatment are reviewed.
Adenocarcinoma↗
Xanthogranulomatous pyelonephritis in renal transplant recipient.
Xanthogranulomatous pyelonephritis is reported in the native kidney of a renal allograft recipient. Immunoglobulin deposition in the transplant kidney in the absence of cell-mediated rejection, accompanied by selective cultures showing Escherichia coli from the native kidney, led to the diagnosis. Native nephrectomy resulted in resolution of the patient's chronic bacteriuria and creatinine elevation.
Adult↗
Xanthogranulomatous pyelonephritis in a Malaysian population.
Xanthogranulomatous pyelonephritis is a clinico-pathological entity that is gaining awareness amongst urologists worldwide. It is an unusual chronic inflammatory lesion involving the kidney that destroys renal parenchyma and may mimic renal carcinoma. It is usually seen in middle-aged women and is associated with urinary tract infections and urinary calculi. Most reports and reviews of this condition come from the West; this study reviews the incidence and presentation of the condition in a Malaysian population.
Adult↗
Xanthogranulomatous pyelonephritis in renal allografts: report of 2 cases.
We report 2 cases of xanthogranulomatous pyelonephritis that occurred in renal transplant recipients. Both cases were successfully treated with antibiotics. The traditional treatment of choice has been nephrectomy. No graft was lost as a result of xanthogranulomatous pyelonephritis and no nephrectomy was required in either patient. The course of these 2 patients is discussed and literature on this disease is reviewed.
Female↗
Xanthogranulomatous pyelonephritis in children.
We report on a child with xanthogranulomatous pyelonephritis--an uncommon entity in children. A review of the literature revealed that in only 18 per cent was the diagnosis made correctly preoperatively. In children the disease is of a focal nature rather than a diffuse one, suggesting that possibly radical surgery would be less necessary for adequate treatment.
Child, Preschool↗
CT findings in xanthogranulomatous pyelonephritis with coexistent renocolic fistula.
A case of diffuse xanthogranulomatous pyelonephritis of the kidney with an associated renocolic fistula is reported. Computed tomography demonstrated typical findings with an enlarged poorly functioning kidney with multiple near-water-density masses replacing the renal parenchyma surrounding a central staghorn calculus. A mottled gas collection within the renal parenchyma was secondary to a renocolic fistula rather than a pyogenic abscess.
Abscess↗
[Xanthogranulomatous pyelonephritis].
OBJECTIVE: To study the diagnosis and treatment of xanthogranulomatous pyelonephritis (XGP). METHOD: The clinical characteristics, diagnosis and therapy of 28 cases of XGP were discussed. RESULTS: The clinical characteristics of XGP included: calculi or obstruction in urinary tract, and damage to kidney; complication of urinary tract infection; anemia, increased ESR and dysfunction of liver. 13 patients with XGP were diagnosed before operation. Nephrectomy was performed in 20 patients. Kidneys were preserved in 8 patients. All patients recovered after operation. CONCLUSIONS: The clinical characteristics and image of XGP are good to preoperative diagnosis. They are useful to differentiate XGP from renal carcinoma and other renal infectious disease. Surgery and antimicrobial are important to XGP. Nephrectomy might be done in patients of stage III kidney may be preserved in patients of stage I and stage II.
Adolescent↗
Megalocytic interstitial nephritis, xanthogranulomatous pyelonephritis, and malakoplakia. An ultrastructural comparison.
Light-microscopic and ultrastructural examinations of megalocytic interstitial nephritis, xanthogranulomatous pyelonephritis, and malakoplakia of the kidney were compared. The cases of megalocytic interstitial nephritis and xanthogranulomatous pyelonephritis represent the first reported electron-microscopic studies on human kidney of these diseases. The study confirmed the presence of a polymorphous cellular infiltrate with predominate histiocytes containing crystalloid material in the case of megalocytic interstitial nephritis; a polymorphous cellular infiltrate with histiocytes predominating in the case of xanthogranulomatous pyelonephritis; and macrophages containing Michaelis-Gutmann bodies in the case of malakoplakia. The characteristic sites of involvement within the kidney by each of the three lesions are discussed. It is believed that the lesions are distinct entities, but related to one another, and represent varied and unusual host responses to inflammation.
Female↗
Tumefactive xanthogranulomatous pyelonephritis.
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Humans↗
Xanthogranulomatous pyelonephritis.
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Carcinoma↗
Xanthogranulomatous pyelonephritis associated with a congenital caliceal diverticulum.
We report a rare case of xanthogranulomatous pyelonephritis occurring in a caliceal diverticulum in a 1-year-old child. She presented with recurrent urinary tract infections. A computed tomography scan demonstrated an enhancing cystic lesion in the left kidney. At open exploration, a caliceal diverticulum was found with a very stenotic opening into the renal pelvis. The diverticulum was enucleated, and the pathologic examination confirmed xanthogranulomatous pyelonephritis in the parenchyma surrounding the diverticulum. The child did well postoperatively with no recurrence of her urinary tract infections.
Diverticulum↗