Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients

ABSTRACT Xanthogranulomatous pyelonephritis is an unusual variant of chronic pyelonephritis in which there is massive destruction of the renal parenchyma by granulomatous tissue. The pathophysiological mechanism is not yet fully understood, and the diagnosis is challenging. This is a rare and sporadic diagnosis in the pediatric population. Here, we report a case of a 2-year-old girl with a one-year history of urinary tract infections and recurrent cloudy urine with traces of sand. Several urinalyses demonstrated pyuria without bacteria growth, and she was admitted to the pediatric nephrology unit. Imaging tests were performed and a xanthogranulomatous pyelonephritis was diagnosed. After confirmation of functional exclusion of the right kidney, a successful right nephrectomy was performed, and the histology confirmed the diagnosis. This case highlights the importance of complementary tests, in a child with signs and symptoms of urinary tract dysfunction, to exclude any pathology requiring therapeutic intervention.

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Main Authors: Gonçalves,Carolina Ferreira, Fernandes,Carolina Freitas, Pilar,Carla, Alves,Fátima, Borges,Maria João
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Nefrologia 2023
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100031
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spelling oai:scielo:S0872-016920230001000312023-05-22Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged PatientsGonçalves,Carolina FerreiraFernandes,Carolina FreitasPilar,CarlaAlves,FátimaBorges,Maria João Child Pyelonephritis, Xanthogranulomatous/diagnosis ABSTRACT Xanthogranulomatous pyelonephritis is an unusual variant of chronic pyelonephritis in which there is massive destruction of the renal parenchyma by granulomatous tissue. The pathophysiological mechanism is not yet fully understood, and the diagnosis is challenging. This is a rare and sporadic diagnosis in the pediatric population. Here, we report a case of a 2-year-old girl with a one-year history of urinary tract infections and recurrent cloudy urine with traces of sand. Several urinalyses demonstrated pyuria without bacteria growth, and she was admitted to the pediatric nephrology unit. Imaging tests were performed and a xanthogranulomatous pyelonephritis was diagnosed. After confirmation of functional exclusion of the right kidney, a successful right nephrectomy was performed, and the histology confirmed the diagnosis. This case highlights the importance of complementary tests, in a child with signs and symptoms of urinary tract dysfunction, to exclude any pathology requiring therapeutic intervention.info:eu-repo/semantics/openAccessSociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology & Hypertension v.37 n.1 20232023-03-01info:eu-repo/semantics/reporttext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100031en10.32932/pjnh.2023.02.226
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country Portugal
countrycode PT
component Revista
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databasecode rev-scielo-pt
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region Europa del Sur
libraryname SciELO
language English
format Digital
author Gonçalves,Carolina Ferreira
Fernandes,Carolina Freitas
Pilar,Carla
Alves,Fátima
Borges,Maria João
spellingShingle Gonçalves,Carolina Ferreira
Fernandes,Carolina Freitas
Pilar,Carla
Alves,Fátima
Borges,Maria João
Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
author_facet Gonçalves,Carolina Ferreira
Fernandes,Carolina Freitas
Pilar,Carla
Alves,Fátima
Borges,Maria João
author_sort Gonçalves,Carolina Ferreira
title Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
title_short Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
title_full Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
title_fullStr Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
title_full_unstemmed Case Report of Xanthogranulomatous Pyelonephritis: A Rare Diagnostic in Pediatric Aged Patients
title_sort case report of xanthogranulomatous pyelonephritis: a rare diagnostic in pediatric aged patients
description ABSTRACT Xanthogranulomatous pyelonephritis is an unusual variant of chronic pyelonephritis in which there is massive destruction of the renal parenchyma by granulomatous tissue. The pathophysiological mechanism is not yet fully understood, and the diagnosis is challenging. This is a rare and sporadic diagnosis in the pediatric population. Here, we report a case of a 2-year-old girl with a one-year history of urinary tract infections and recurrent cloudy urine with traces of sand. Several urinalyses demonstrated pyuria without bacteria growth, and she was admitted to the pediatric nephrology unit. Imaging tests were performed and a xanthogranulomatous pyelonephritis was diagnosed. After confirmation of functional exclusion of the right kidney, a successful right nephrectomy was performed, and the histology confirmed the diagnosis. This case highlights the importance of complementary tests, in a child with signs and symptoms of urinary tract dysfunction, to exclude any pathology requiring therapeutic intervention.
publisher Sociedade Portuguesa de Nefrologia
publishDate 2023
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692023000100031
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