Xanthogranulomatous pyelonephritis treated by partial nephrectomy.
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.
Chang
Jei-Wen
JW
Department of Pediatrics, Taipei Veterans General Hospital and Tao Yuan Veterans Hospital, National Yang-Ming University, Taiwan.
Chen
Shu-Jen
SJ
Chin
Tai-Wai
TW
Tsai
Hsin- Lin
H
Pan
Chin-Chen
CC
Chu
Yum-Kung
YK
Tiu
Chui-Mei
CM
Yang
Ling-Yu
LY
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D009392:Nephrectomy; D011705:Pyelonephritis, Xanthogranulomatous / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002216:Captopril