Xanthogranulomatous pyelonephritis in childhood.
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BACKGROUND: Xanthogranulomatous pyelonephritis is a severe, atypical form of chronic renal parenchymal infection accounting for 6/1000 surgically proved cases of chronic pyelonephritis. Its manifestations mimic those of neoplastic and other inflammatory renal parenchymal diseases and, consequently, it is often misdiagnosed preoperatively. AIM: To examine the relation between clinical history and the results of renal investigations performed in children with xanthogranulomatous pyelonephritis. METHOD: A retrospective review of 31 cases presenting with the histopathological diagnosis of xanthogranulomatous pyelonephritis between 1963 and 1999. RESULTS: The mean follow up was 8.2 years. The male:female ratio was 1:1.1. The left kidney was affected in 26 of the 31 patients. The positive findings on examination and investigation at presentation were: fever, 16 children; pyuria, 26 children; positive urine culture, 16 children. A haemoglobin of < 100 g/l was measured in 27 of 31 patients and 15 of 18 patients tested had a raised erythrocyte sedimentation rate of > 20 mm in the first hour. Twenty six children had renal calculi, with a large reduction in the function of the affected kidney on isotope scintigraphy in 27 of the 29 patients tested. Hypertrophy of the contralateral kidney, shown on imaging, was present in 17 of 31 patients. CONCLUSIONS: Increasing awareness of this condition should lead to the diagnosis being suspected preoperatively. (+info)
Xanthogranulomatous pyelonephritis presenting as emphysematous pyelonephritis: a rare association.
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Xanthogranulomatous and emphysematous pyelonephritis are two rare variants of pyelonephritis. Their combined occurrence is a very rare condition, which has been documented in our case. (+info)
Superior vena cava syndrome due to fibrosing mediastinitis histologically identical to xanthogranulomatous pyelonephritis.
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We present herein a case of superior vena cava (SVC) syndrome caused by localized fibrosing mediastinitis (FM), which had histological features similar to xanthogranulomatous pyelonephritis (XGP). A 63-year-old woman presented with facial swelling 5 months after undergoing right nephrectomy for XGP. Radiologic investigations of the chest confirmed the presence of SVC obstruction due to an intraluminal tumor. The histological features of the tumor were consistent with those of FM and were very similar to those of XGP. Although the pathogenesis of neither FM nor XGP is known, some pathogenic process of FM and XGP may be the same. (+info)
Ultrasonographic features of focal xanthogranulomatous pyelonephritis.
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OBJECTIVE: To analyze the ultrasonographic features of focal xanthogranulomatous pyelonephritis. METHODS: Ultrasonographic features of 15 patients with pathologically proved focal xanthogranulomatous pyelonephritis were retrospectively analyzed by 2 radiologists who reached a consensus, in terms of the location, margin, size, and echo texture of the mass, associated calculi, lymphadenopathy, or local extension, in comparison with computed tomographic and clinical findings. RESULTS: At ultrasonography, 12 (80%) of 15 masses were well circumscribed. The maximal sizes of the masses ranged from 2.5 to 5.8 (mean, 3.8) cm. Thirteen solid masses (87%) were hyperechoic (n = 7), hypoechoic (n = 4), or isoechoic (n = 4) to the renal cortex, and the preoperative diagnosis was either renal cell carcinoma (n = 11) or Wilms tumor (n = 2). The preoperative diagnosis of the other 2 cystic lesions (13%) was renal abscess. Renal calculi were found in 1 case, but lymphadenopathy or local extension was not depicted. Clinical inflammatory signs were found in 11 of 15 patients. CONCLUSIONS: There were no specific ultrasonographic features that allow for the distinction between focal xanthogranulomatous pyelonephritis and renal tumors or abscesses. Focal xanthogranulomatous pyelonephritis should be considered when there are clinical signs of infection or inflammation and a focal solid mass is seen on ultrasonography. (+info)
Xanthgranulomatous pyelonephritis associated with Staphylococcus aureus.
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A 44-year old man with xanthogranulomatous pyelonephritis presented with abdominal distention, left lumber pain, fever, loss of appetite, and loss of weight. He had been known to have diabetes mellitus type II for 20 years, and he was diagnosed to have a left renal stone three months prior to this presentation. The patient's urine and the left psous abscess grew staphylococcus aureus. (+info)
Preoperative diagnosis of xanthogranulomatous pyelonephritis.
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INTRODUCTION: The aim of this study was to evaluate the possibility of differentiating xanthogranulomatous pyelonephritis (XGPN) preoperatively from chronic pyelonephritis on the basis of demographic data, clinical parameters, and biochemical, microbiological, and radiological workups. MATERIALS AND METHODS: Between 1995 and 2005, a total of 239 patients were diagnosed to have pyelonephritis at our center, of which, 56 underwent nephrectomy. Forty-five (80.4%) of the nephrectomy specimens showed diagnosis of chronic pyelonephritis and 11 (19.6%) showed XGPN. RESULTS: Compared to chronic pyelonephritis, XGPN was more likely to occur in the middle-aged women (90.9%) with diabetes mellitus (63.6%). A positive history of UTI was more frequent in these patients, too. The disease was likely to present with flank pain and tenderness in 100.0% and 90.9% of the patients with XGPN, respectively. Anemia (81.8%), hematuria (81.8%), and bacteriuria (90.9%) were more frequent in these patients than in those with chronic pyelonephritis. The mean blood hemoglobin was 7.0 g/dL in the patients with XGPN. Proteus mirabilis was detected in 6 patients (54.5%) of the XGPN group and only 2 of the chronic pyelonephritis group (P < .001). Renomegaly and kidney calculus were more frequently noted in the patients with XGPN. Finally, XGPN led to a higher rate of postoperative complications. CONCLUSION: Demographic data, comorbidities, predisposing factors, and biochemical as well as roentgenological features are significant but nonspecific indicators of preoperative diagnosis of XGPN. (+info)
Ischemic colitis secondary to xanthogranulomatous pyelonephritis.
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