Xanthogranulomatous pyelonephritis—an unusual renal disease in childhood

Abstract

We report on a 6-year-old boy with Xanthogranulomatous pyelonephritis. This unusual type of renal inflammation has a typical clinical picture that is important to bear in mind. The affected child is often seriously ill with a palpable flank mass leading to initial suspicion of malignancy. Modern imaging procedures help in obtaining a pre-operative diagnosis.

Xanthogranulomatous pyelonephritis presenting as intra‐abdominal tumor in a child

“…It is thought that XGP is a morphological variant of chronic pyelonephritis. This form of pyelonephritis differs from typical chronic pyelonephritis because of the abundant infiltrate of foam cells, which are thought to be macrophage loaded with lipids in XGP 1,9 …”

“…1 Xanthogranulomatous pyelonephritis should be considered, if there is evidence of local or diffuse destruction of renal parenchyma, poor renal function and clinical features of urinary obstruction or/and urinary infection. 1,8,9 Among physical features, palpable mass is a common finding. The ratio of a palpable mass in a different study was reported as 33 and 66%.…”

“…This form of pyelonephritis differs from typical chronic pyelonephritis because of the abundant infiltrate of foam cells, which are thought to be macrophage loaded with lipids in XGP. 1,9 Early diagnosis and treatment of XGP is especially important in patients with a functioning kidney worth preserving. 1 The usual treatment has been total or partial nephrectomy.…”