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PubMed1997

[Xanthogranulomatous pyelonephritis: experience at the General Hospital of Albacete. Report of 16 cases].

A retrospective study of 16 Xanthogranulomatous Pyelonephritis (XGP) cases seen during a 12-years period (1983-1994) at the Hospital General de Albacete was performed. An analysis is made of the clinical features, laboratory data and imaging diagnostic techniques, comparing our findings with those of several series published in the literature. The outcome of this study is that clinical and biological picture of XGP is characteristic: Middle-aged woman admitted to a Internal Medicine Service because a constitutional syndrome, with important weight loss, general poor health, acceleration of erythrocyte sedimentation rate (ESR), anemia, hepatic disfunction and renal destruction imagings, frequently with renal stone and urinary tract infection history. This characteristics can be useful to suspect a XGP.

Aged↗

PubMedDate not supplied

[The use of thienam for the emergency antibacterial therapy of acute suppurative pyelonephritis].

Results of a clinical and microbiological investigation designed to study thienam permit recommending this drug as an urgent agent of choice in acute purulent pyelonephritis. The drug is well tolerated. Among other benefits is extremely high sensitivity of bacteria (pathogenic and conditionally pathogenic) to the medication, achievement of an expected clinical effect within a short time since its therapy institution.

Abscess↗

PubMed1997

Renocolic fistula as a complication to xanthogranulomatous pyelonephritis.

Four patients with xanthogranulomatous pyelonephritis were found to have renocolic fistulae. Coincidentally, the left kidney was involved in all four cases. All patients presented with renal mass. Two cases have had coexistent renal stones, one of them presented with massive upper gastrointestinal bleeding as a result of portal hypertension. Another patient had a history of Schistosomiasis. In none of the patients was the renal condition confidently diagnosed preoperatively, nor was the colonic fistula suspected. In all four patients, nephrectomy was performed together with resection of the involved colon followed by a satisfactory recovery. The possibility of a colonic fistula should be kept in mind as a complication to this rare renal condition in spite of the absence of colonic symptoms and normal finding in barium enema studies.

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↗

PubMed1998

Incomplete urethral obstruction associated with dilatation of the urethra, cystitis, and pyelonephritis in a Vietnamese pot-bellied pig.

A 2-year-old castrated male vietnamese pot-bellied pig examined because of stranguria was found to have severe dilatation and inflammation of the pelvic portion of the urethra accompanied by cystitis and pyelonephritis. The pig had apparently had chronic inflammation of the urinary tract that eventually progressed to incomplete obstruction of the urethra. However, the initial cause of the urinary tract inflammation could not be determined. Possible causes included chronic bacterial infection, traumatic injury during urethral catheterization, and injury to the urethral mucosa secondary to extreme acidification of the urine.

Animals↗

PubMedDate not supplied

[The treatment of suppurative pyelonephritis].

From 1986 in the urological clinic of the Dagestan Medical Academy 82 patients received surgical treatment for purulent pyelonephritis caused by urinary occlusion. Nephrostoma or pyelostoma were applied in most of the patients. In the postoperative period the patients were given antiinflammatory and infusion therapy. Recently, 40 patients were exposed to adjuvant laser treatment. The comparison of the treatment results demonstrated better outcomes in patients exposed to laser radiation. Normalization of renal function, T- and B-immunity in them was faster.

Acute Disease↗

PubMed1976

[Xanthogranulomatous pyelonephritis].

Based on literature and own case the entity of xanthogranulomatous pyelonephritis is reviewed. In particular are discussed the difficulties of the preoperative diagnostic procedures and the differential diagnosis.

Diagnosis, Differential↗

PubMed1976

Xanthogranulomatous pyelonephritis. Angiographic observations made in one case at an interval of six years.

In a woman aged 67, comprehensive angiographic examination revealed an extensive renal process which had led to thrombosis of the inferior vena cava. At exploratory surgery the process seemed inoperable. The angiographic study was repeated after an asymptomatic period of 6 years and disclosed shrinking of the kidney involved. Revision of the microscopic findings altered the initial diagnosis of renal carcinoma in favour of xanthogranulomatous pyelonephritis. The observation is of interest by virtue of the characteristic angiographic findings, extension of the process to the venous system, and angiographic evidence that spontaneous regression is possible.

Aged↗

PubMed1998

Chronic nephrotic syndrome and chronic renal failure by amyloidosis secondary to xanthogranulomatous pyelonephritis.

The association of xanthogranulomatous pyelonephritis (XPN) and systemic amyloidosis is extremely rare. This association has been described in only six cases. We present a 4-year-old male admitted with a history of anuria and abdominal pain. Investigations revealed multiple calculi in both kidneys. A right pyelolithotomy and left nephrectomy were performed. Histological examination demonstrated XPN and amyloidosis. At discharge serum creatinine had dropped to 1.1 mg/dl but after being lost to follow up for 9 years, the child was readmitted because of edema. Laboratory examination revealed a nephrotic syndrome and serum creatinine of 2.3 mg/dl. Rectal biopsy showed the presence of amyloid. A treatment by colchicine was unsuccessful. Fifteen months later, at the age of 15 years, the patient developed terminal renal failure (serum creatinine 14 mg/dl).

Amyloidosis↗

PubMedDate not supplied

[Immune system function in patients with acute pyelonephritis].

As many as 296 patients with acute pyelonephritis were evaluated for parameters characterizing their immunological status. The results were as follows: decreased levels of T-lymphocytes, T-helpers, and immunoregulatory index in 42%, 87% and 72% respectively. In normal indices of spontaneous test with nitroblue tetrazolium stimulated below the norm was in 71% of cases. A study involving the use of monoclonal antibodies revealed no changes in the EK-cells counts, while their functional activity was decreased in 52% of patients. The functional activity of lymphocytes in the reaction of blast transformation in response to phytohemagglutinin and PWM was running down in 83% and 75% of cases respectively. With high levels of blood serum IgA and IgM the number of the immune complexes was noted to be on the increases in 68% of patients. The level of spontaneous productions of IL-1 was normal whereas that of IL-2 elevated, with the stimulated production of there mediators in AP patients being significantly below the norm.

Acute Disease↗

PubMedDate not supplied

[Copper and zinc metabolic derangement in patients with chronic pyelonephritis developing nephrosclerosis and renal insufficiency].

Cu and Zn levels were measured (nuclear-absorption spectrophotometry) in the blood and urine from patients with chronic pyelonephritis (CP) in emergence of nephrosclerosis and renal insufficiency. CP patients were found to develop hypercupremia as early as initial stages of nephrosclerosis when renal insufficiency was not apparent. Blood Zn was low, especially in development of chronic renal insufficiency. Cu and Zn disbolism may contribute to formation of sclerotic lesions in the kidneys and to development of chronic renal insufficiency. Assay for Cu and Zn is proposed for early diagnosis of nephrosclerosis and provides objective clinical control over the disease course to make timely correction of the detected defects and valid prognosis.

Adult↗

PubMed1997

Emphysematous pyelonephritis responding to medical therapy.

We describe two type 2 diabetic patients with unilateral emphysematous pyelonephritis who responded to medical treatment alone. Escherichia coli was isolated in both patients. The presence of gas was confirmed early by ultrasound and CT scan of abdomen. Following treatment, good functional recovery was demonstrable in the affected kidneys by isotope renogram. We stress the need for early diagnosis of this condition and aggressive treatment with broad spectrum antibiotics.

Diabetes Complications↗

PubMed1997

Economic issue in pediatric nuclear medicine: cortical scanning of acute pyelonephritis.

Pediatric nuclear medicine, in order to survive, must be innovative in finding ways of competing with other pediatric imaging subspecialties for the health care dollars. Newer radiopharmaceuticals and imaging methods that are time-effective in answering clinical problems and cost-effective in attracting the health care providers are ways of accomplishing this difficult task. Renal cortical scanning for the diagnosis of acute pyelonephritis is presented as an example of an existing nuclear medicine study that is accurate and cost-effective, but has not yet taken a major place in the imaging armamentarium. In this discussion, the cortical scan is endorsed as the primary imaging tool for children presenting with acute urinary infection.

Acute Disease↗

PubMed1998

[Urinary excretion of glycosaminoglycans in patients with chronic pyelonephritis and chronic glomerulonephritis].

Glycosaminoglycanes (GAG) were measured in 24-h urine of patients with chronic pyelonephritis (CP) and chronic glomerulonephritis (CGN) at different stages of nephrosclerosis. These patients developed hyperglycosaminoglycanuria at early stages of nephrosclerosis before establishment of chronic renal failure. There is a positive correlation between the severity of excretion of GAG and leukocyturia in CP patients (p < 0.05). Estimation of GAG 24-h urinary excretion can help evaluate metabolism of connective tissue of the kidneys in CP and CGN patients for early diagnosis of nephrosclerosis, control of the treatment efficacy and the disease prognosis. It can also serve as additional criterion for rating of inflammation. The method is non-invasive, informative, available for clinical diagnostic laboratories.

Adult↗

PubMed1998

[Significance of daily hydroxyprolinuria in the early diagnosis of nephrosclerosis in patients with chronic pyelonephritis].

Studies of daily excretion of hydroxyproline with the urine in patients with chronic pyelonephritis (CP) showed manifest hyper-hydroxyprolinuria at the early stages of the disease, which augmented with the development of renal insufficiency. Measurement of hydroxyproline in the urine of CP patients is proposed as a test reflecting the renal connective tissue metabolism at the early stages of the disease. It can be used for assessing the activity of the sclerotic process in the kidneys of CP patients, for predicting the disease course and outcome, and, probably, for developing methods of adequate pathogenetic therapy based on biochemical monitoring. The method is noninvasive, sufficiently informative, and available for clinical diagnostic laboratories.

Adolescent↗

PubMedDate not supplied

[Hormonal disorders in patients with chronic pyelonephritis with nephrosclerosis and kidney failure].

Blood plasma content was studied of hydrocortisone, parathyroid hormone (PTH) and calcitonin in patients with chronic pyelonephritis (ChP) using methods of radioimmunologic and immunoenzymatic analyses. ChP patients had marked alterations of blood plasma levels of hydrocortisone, PTH and calcytonin, with the reduced levels of hydrocortisone and hypercalcitoninamia being noted during the early stages of nephrosclerosis. It is suggested that hydrocortisone and calcitonin content in blood of ChP patients might be used as indicators of state of the endocrine mechanisms controlling the renal connective tissue metabolism during the early stages of nephrosclerosis. The above measure will also be helpful in the assessment of activity of the sclerotic process in the kidneys, prognosis of the outcome of the medical condition, and development of treatment options of adequate pathogenetic therapy.

Adult↗

PubMed1976

[Functional and urinary analysis diagnosis of pyelonephritis].

For the practicing physician pyelonephritis is a frequently observed clinical picture which still has its diagnostic problems. With the help of a step programme a reasonable diagnostics is striven for which gives the possibility of an early recognition in the general surgery and a far-reaching clarification of the clinical picture in the out-patient department.

Chronic Disease↗

PubMed1998

[Retrograde cystography after a first episode of acute pyelonephritis in the child and adolescent].

In spite of its invasiveness, voiding cystourethrography remains the gold-standard examination for detecting vesico-ureteric reflux. The aim of this study was to determine if voiding cysto-urethrography is useful at any pediatric age in girls after a first acute pyelonephritis. 152 patients have been retrospectively studied. Both reflux frequency and grade progressively decreased according to age. Sonography was unable to predict reflux. In more than 3-year-old girls, 8/30 children with reflux had voiding dysfunction. We suggest clinical and/or a flow-metric evaluation for voiding dysfunction prior to voiding cystourethrography. After 9 years, reflux was so rare that voiding cystourethrography should be discussed on an individual basis.

Acute Disease↗