Xanthogranulomatous pyelonephritis due to calculi in a 5-year-old girl.


Journal

The Turkish journal of pediatrics
ISSN: 2791-6421
Titre abrégé: Turk J Pediatr
Pays: Turkey
ID NLM: 0417505

Informations de publication

Date de publication:
2020
Historique:
entrez: 12 8 2020
pubmed: 12 8 2020
medline: 20 8 2021
Statut: ppublish

Résumé

Xanthogranulomatous pyelonephritis is characterized by the inflammatory destruction of the renal parenchyma and intensive renal fibrosis. It is named because of its pathological appearance; that of its granulomatous inflammatory process with lipid-laden macrophages, which appear yellow, hence `xantho` which is Greek for yellow. Xanthogranulomatous pyelonephritis is predominantly a disease of adults. In children it is diagnosed sporadically and is extremely rare in infants. The age of onset varies (21 days to 16 years), although 60-75% of cases have been diagnosed before 5 years of age. Recurrent urinary tract infections, obstructive nephropathy caused by renal calculus, malnutrition, abnormal lipid metabolism, altered immunologic response, lymphatic blockage, congenital urinary anomalies have been implicated in the etiology of xanthogranulomatous pyelonephritis in children. We report an unusual case of xanthogranulomatous pyelonephritis in a 5-year-old girl and discuss its clinical features, histopathological findings and treatment. In this article, we also emphasized the importance of diagnostic imaging in urinary tract infections which enabled us not to miss the underlying kidney stone disease. Nephrolithiasis may lead to very serious conditions such as xanthogranulomatous pyelonephritis. This condition can be easily diagnosed by ultrasound, but if not detected, it can lead to complete loss of renal function as in the case.

Sections du résumé

BACKGROUND
Xanthogranulomatous pyelonephritis is characterized by the inflammatory destruction of the renal parenchyma and intensive renal fibrosis. It is named because of its pathological appearance; that of its granulomatous inflammatory process with lipid-laden macrophages, which appear yellow, hence `xantho` which is Greek for yellow. Xanthogranulomatous pyelonephritis is predominantly a disease of adults. In children it is diagnosed sporadically and is extremely rare in infants. The age of onset varies (21 days to 16 years), although 60-75% of cases have been diagnosed before 5 years of age. Recurrent urinary tract infections, obstructive nephropathy caused by renal calculus, malnutrition, abnormal lipid metabolism, altered immunologic response, lymphatic blockage, congenital urinary anomalies have been implicated in the etiology of xanthogranulomatous pyelonephritis in children.
CASE
We report an unusual case of xanthogranulomatous pyelonephritis in a 5-year-old girl and discuss its clinical features, histopathological findings and treatment. In this article, we also emphasized the importance of diagnostic imaging in urinary tract infections which enabled us not to miss the underlying kidney stone disease.
CONCLUSION
Nephrolithiasis may lead to very serious conditions such as xanthogranulomatous pyelonephritis. This condition can be easily diagnosed by ultrasound, but if not detected, it can lead to complete loss of renal function as in the case.

Identifiants

pubmed: 32779427
pii: 2199
doi: 10.24953/turkjped.2020.04.024
doi:
pii:

Types de publication

Case Reports

Langues

eng

Sous-ensembles de citation

IM

Pagination

690-693

Auteurs

Esra Nagehan Akyol-Önder (EN)

Departments of Pediatric Nephrology, Celal Bayar University, Faculty of Medicine Manisa, Turkey.

Mine Özkol (M)

Departments of Radiology, Celal Bayar University, Faculty of Medicine Manisa, Turkey.

Nalan Neşe (N)

Departments of Pathology, Celal Bayar University, Faculty of Medicine Manisa, Turkey.

Can Taneli (C)

Departments of Pediatric Surgery, Celal Bayar University, Faculty of Medicine Manisa, Turkey.

İpek Özünan (İ)

Departments of Pediatric Nephrology, Celal Bayar University, Faculty of Medicine Manisa, Turkey.

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