Malacoplakia: A Study of the Literature and Current Concepts of Pathogenesis, Diagnosis and Treatment

Stanton, Michael J.; Maxted, William C.

doi:10.1016/s0022-5347(17)54940-x

Cited by 293 publications

(295 citation statements)

References 81 publications

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“…It is a chronic inflammatory disease that affects the genitourinary tract with a special affinity for bladder. Though there is female preponderance in the genital tract, yet in general, males above the age of 50 years are more affected [1]. The symptoms of bladder malakoplakia are hematuria and signs of urinary tract infection such as hesitancy, dysuria, and frequency.…”

Section: Discussionmentioning

confidence: 99%

“…Nearly 90% of the patients have urine infections by coliforms and 40% have autoimmune disease or some type of immunodeficiency [1]. E coli are the most common gram-negative bacteria isolated.…”

Section: Discussionmentioning

confidence: 99%

“…Malakoplakia can affect all body organs; bladder being the most frequently affected one, particularly in females [1]. Patients of any age may develop malakoplakia, but the peak occurrence is in middle age.…”

Section: Introductionmentioning

confidence: 99%

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An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

et al. 2009

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IntroductionMalakoplakia is an unusual chronic inflammatory disease. Malakoplakia of the bladder and ureter is quite rare.Case presentationWe present a case of a young male diagnosed as malakoplakia of urinary bladder and ureter. He presented with bilateral hydroureteronephrosis. The patient underwent left ureterocystotomy. Again, he was admitted after a gap of ten years and with features of end stage renal disease.ConclusionThis rare case of urinary bladder and ureter malakoplakia in a young male is presented, to stress upon the fact that though it is a chronic inflammatory disease, yet its outcome over the years is dismal.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

et al. 2009

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“…[4]. The exact pathogenesis is not fully understood, but most patients have urine infections by E. coli, and 40% of them are associated with some type of immunodeficiency or malignancy [2]. We hereby present an unusual case of a woman who was diagnosed to have bladder malakoplakia, which later progressed to renal failure within a period of three years.…”

Section: Introductionmentioning

confidence: 91%

“…Malakoplakia is a rare chronic inflammatory disease which was first described in 1902 by Michaelis and Gutmann [1], and is more common in females [2]. It commonly affects the genitourinary system with bladder being the most frequently affected organ [3].…”

Section: Introductionmentioning

confidence: 99%

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Wong¹,

Yeung²,

Lee³

et al. 2016

JCR

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Abstract:Introduction: Malakoplakia is a rare chronic inflammatory disease which commonly affects the urogenital tract. The exact pathogenesis is not fully understood, but some associated conditions which include immunodeficiency, malignancy or chronic bacterial infection, have been suggested. The definite diagnosis relies on identifying the Michaelis-Gutmann bodies microscopically. Case Report: A 62-year-old woman with poorly controlled diabetes mellitus presented with gross hematuria for a few months. Subsequent investigations showed a positive urine culture (Escherichia coli -E. coli), and flexible cystoscopy showed a 1 cm plaque-like lesion at the left posterior wall of the urinary bladder as well as several smaller, similar lesions noted at various different sites. Biopsy of the lesion showed a proliferation of macrophages (CD68+) with abundant, glandular cytoplasm and the presence of Michaelis-Gutmann bodies (PAS+, Von Kossa+), which was consistent with malakoplakia. Computed Tomography (CT) urogram showed no hydronephrosis, with good contrast excretion from both kidneys as well as satisfactory drainage down to the bladder. She was then treated with antibiotics, but still had on and off urinary tract infection. About a year later, she presented with urosepsis and acute renal failure, and was admitted to the urological ward. Urgent CT urogram showed bilateral hydronephrosis with both lower ureters distended with hyperdense contents (malakoplakia plaques). Emergency bilateral percutaneous nephrostomy (PCN) was performed. Her condition was stabilized with antibiotics, and her renal function improved with PCN drainage. Several treatment options were offered to the patient, but in view of her significant pre-morbid condition, she opted for bilateral long-term PCN. Conclusion: Malakoplakia was thought to be a treatable and relatively benign disease, but in some cases, it might result in renal failure due to bilateral ureteric involvement. Early diagnosis together with adequate antibiotic treatment is important in patients with malakoplakia, and they should be closely followed up to prevent future development of renal insufficiency.

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Malacoplakia. Two case reports and a comparison of treatment modalities based on a literature review

Voort

Velden²,

Wassenaar³

et al. 1996

Archives of Internal Medicine

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Malacoplakia is a rare infectious disease that has been almost exclusi vely reported in urology and pathology journals. We studied two cases of malacoplakia that were primarily referred to the department of internal medicine because of fever and abdominal masses. In one patient, malacoplakia was diagnosed in the unusual ovarian location, while in the other patient a large renal mass was found and ciprofloxacin therapy failed because of bacterial resistance. The clinical and radiologic appearance of malacoplakia often mimics that of a malignant tumor. The principal disorder is probably a monocytic-macrophagic bactericidal defect. A definitive diagnosis depends on microscopic detection of Michaelis-Gutmann bodies by means of von Kossa stain. We outlined treatment strategies on the basis of a review of the literature since 1981, which included 140 cases. If possible, immunosuppressive drugs should be stopped. Quinolone antibiotic treatment and surgical excision or incision and drainage lead to the highest cure rates (90% and 81%, respectively). Specific intracellular penetration of quinolone antibiotics is a possible reason for the higher cure rate achieved with these antibiotics. Bethanechol has been suggested to correct the supposed fundamental disturbance by increasing the intrecellular cyclic guanosine monophosphate concentration, but there is still no convincing evidence of its clinical efficacy.

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Malacoplakia: A Study of the Literature and Current Concepts of Pathogenesis, Diagnosis and Treatment

Cited by 293 publications

References 81 publications

An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Malacoplakia. Two case reports and a comparison of treatment modalities based on a literature review

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