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2018 ; 18
(1
): 57
Nephropedia Template TP
gab.com Text
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Nephron-sparing management of Xanthogranulomatous pyelonephritis presenting as
spontaneous renal hemorrhage: a case report and literature review
#MMPMID29866085
Ballentine WK 3rd
; Vilson F
; Dyer RB
; Mirzazadeh M
BMC Urol
2018[Jun]; 18
(1
): 57
PMID29866085
show ga
BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon infectious
disease of the kidney known to mimic other renal maladies. A rare presentation of
this uncommon disease is spontaneous renal hemorrhage (SRH). CASE PRESENTATION:
We report a case of XGP in a 58 year old woman who presented with abdominal pain,
hematuria, and radiating left flank pain. CT scan was felt to be consistent with
perirenal hemorrhage abutting a fat-containing renal mass. The patient was
eventually taken to surgery for left partial nephrectomy. Pathology report
returned as XGP, and the patient has no complications from this disease process
at 8 month follow up. CONCLUSION: Our search of the literature shows XGP
presenting as SRH to be a rare clinical entity. Furthermore, this is the first
such case managed with a nephron-sparing approach. The "great imitator" XGP
should be added to the differential for patients presenting with spontaneous
renal hemorrhage.