Abstract
Xanthogranulomatous pyelonephritis is an uncommon disease in children. We report of a 2-month-old girl with urinary tract infection and with a renal mass detected by ultrasound scan. The preoperative differential diagnoses were Wilms tumor, multicystic dysplastic kidney, renal abscess, and mesoplastic nephroma. The subsequent histopathological findings allowed the diagnosis of xanthogranulomatous pyelonephritis (XGP). Although XGP is rare at this age, it must be considered in the differential diagnosis of a child presenting with renal mass, either with or without associated urolithiasis, anemia, and elevated inflammatory markers. The long-standing mainstay of therapy for diffuse XGP has been nephrectomy. However, we report the successful preservation of renal mass with partial nephrectomy for diffuse XGP. The affected kidney grew normally and preserved residual function after the operation. Hence we strongly suggest parenchymal saving in pediatric cases of XGP to preserve renal function.
References
Schlagenhaufer F (1916) Ueber eigentumliche Staphylomykosen der Nieren und des pararenalen Bindegewebes. Frankfur Zeitsch Pathol 19:139–148
Braun G, Moussali L, Balanzar JL (1985) Xanthogranulomatous pyelonephritis in children. J Urol 133:236–239
Youngsson GG, Gray ES (1990) Neonatal xanthogranulomatous pyelonephritis. Br J Urol 65:541–542
Levy M, Baual R, Eddy AA( 1994) Xanthogrulomatous pyelonephritis in children. Etiology, pathogenesis, clinical and radiologic features and management. Clin Pediatr (Phila) 33:360–366
Zafranloo S, Gerard PS, Bryk D (1990) Xanthogranulomatous pyelonephritis in children: analysis by diagnosis modalities. Urol Radiol 12:18–21
Malek R, Greene L, De Weerd J, Farrow G (1972) Xanthogranulomatous pyelonephritis. Br J Urol 44:296–308
Goodman M, Curry T, Russell T (1979) Xanthogranulomatous pyelonephritis (XGP): a local disease with systemic manifestations. Report of 23 patients and review of the literature. Medicine (Baltimore) 58:171–181
Rafal RB, Kosovsky PA, Markisz JA (1991) Xanthogranulomatous pyelonephritis in an infant. Urology 37:553–556
Cousins C, Somers J, Broderick N, Rance C, Shaw D (1994) Xanthogranulomatous pyelonephritis in childhood: ultrasound and CT diagnosis. Pediatr Radiol 24:210–212
Tiu CM, Chou YH, Chiou HJ, Lo CB, Yang JY, Chen KK, Hsu MH, Wang JH, Su YG, Chang CY, Yu C (2001) Sonographic features of xanthogranulomatous pyelonephritis. J Clin Ultrasound 29:279–285
Pearsons MA, Harris SC, Grainger RG, Ross B, Smith JA, William JL (1986) Fistula and sinus formation in xanthomatous pyelonephritis. A clinicopathological review and report of four cases. Br J Urol 488–493
Hayes WS, Hartman DS, Sesterhenn IA (1991) From the archives of the AFIP. Xanthogranulomatous pyelonephritis. Radiographics 11:485–498
Sease WC, Elyaderani MK, Belis JA (1987). Ultrasonography and needle aspiration in diagnosis of xanthogranulomatous pyelonephritis. Urology 29:231–235
Ballasteros JJ, Serrano S, Faus R, Gironella J (1983) Urinary cytology in the diagnosis of renal xanthogranulomatous. Eur Urol 9:343–345
Samuel M, Duffy P, Capps S, Mouriquand P, Williams D, Ransley P (2001) Xanthogranulomatous pyelonephritis in childhood. J Pediatr Surg 36 598–601
Brown PS, Dodson M, Weinturb PS (1996) Xanthogranulomatous pyelonephritis: report of nonsurgical management of a case and review of the literature. Clin Infect Dis 22: 308–314
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Chang, JW., Chen, SJ., Chin, TW. et al. Xanthogranulomatous pyelonephritis treated by partial nephrectomy. Pediatr Nephrol 19, 1164–1167 (2004). https://doi.org/10.1007/s00467-004-1541-x
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DOI: https://doi.org/10.1007/s00467-004-1541-x