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Query: UMLS:C0034186 (pyelonephritis)
 6,144 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Xanthogranulomatous pyelonephritis is considered to be an unusual cellular response to bacterial invasion. This assumption is based on circumstantial evidence and experimental studies. In our electron microscopic study of five cases of xanthogranulomatous pyelonephritis demonstrated a stratification of the cellular components, somewhat resembling that described in the experimental lesions. The center of the xanthogranulomas was occupied by purulent exudate. Bacteria were identified mainly in polymorphonuclear leukocytes and extracellularly in four cases in which central area were available for electron microscopic studies. Many bacteria were located in cytoplasmic vacuoles. more peripherally, histiocytes predominated, and their cytoplasm contained numerous lipid droplets with and without limiting membranes and phagolysosomes. The latter contained electron dense, granular, and membranous structures. The outermost layer of the lesion demonstrated macrophages with a decreased number of lipid droplets and larger intralysosomal particles. Lymphocytes, plasma cells, and fibroblasts represented an increasing proportion of the infiltrate in this layer. Our study suggests that xanthogranulomatous pyelonephritis is a bacteria induced process. Its histological appearance may be related to incomplete bacterial degradation and altered host response.
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PMID:Ultrastructural demonstration of intracellular bacteria in xanthogranulomatous pyelonephritis. 707 94

Xanthogranulomatous pyelonephritis is a rare manifestation of chronic pyelonephritis. 11 cases were treated between 1988 and 1993. Patients age ranged from 17 to 60 years (mean 34 j). A pseudotumoral form was documented in 3 patients and pyonephrosis was found in 8 cases. Urine culture was usually positive for a non specific germ. Imaging technics could differentiate pseudotumoral disease from diffuse disease. Treatment consisted in a nephrectomy.
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PMID:[Xanthogranulomatous pyelonephritis. Apropos of 11 cases]. 772 86

Xanthogranulomatous pyelonephritis is a rare disease that may mimic various renal lesions, especially renal tumors, in its focal form. We report a case of pseudoneoplastic xanthogranulomatous pyelonephritis in a young woman. This case is unusual, because it was diagnosed by a percutaneous renal puncture and furthermore total renal recovery was achieved by antibiotic treatment alone.
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PMID:Pseudoneoplastic xanthogranulomatous pyelonephritis. A typical clinical presentation but unusual diagnosis and treatment. 774 62

Xanthogranulomatous pyelonephritis is an uncommon form of chronic aggressive infection of the kidney and surrounding tissues usually affecting middle aged women. It is rarely seen in childhood. We report the case of a female child with a history of fatigue, progressive anorexia, and fever in whom a diagnosis of pyelonephritis on a predisposing factor of lithiasis was suggested. After initial antibiotic treatment, nephrectomy was needed for an acute general deterioration. Pathology demonstrated xanthogranulomatous pyelonephritis.
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PMID:Xanthogranulomatous pyelonephritis in a child. 829 78

A 47-year-old female was admitted with colicky pain in the left flank. Ultrasonography and abdominal CT revealed left perirenal hematoma. Abdominal CT revealed a multilocular cystic lesion in the upper pole of the left kidney. Renal angiography revealed left renal cell carcinoma. Left nephrectomy was performed under a tentative diagnosis of left renal cell carcinoma. However, pathological diagnosis was xanthogranulomatous pyelonephritis. Xanthogranulomatous pyelonephritis is an atypical form of chronic renal parenchymal infection that can be classified as diffuse type or focal type. Preoperative diagnosis of focal xanthogranulomatous pyelonephritis is difficult because of clinical and radiological similarities to renal cell carcinoma. Our case is presented with a brief review of the literature.
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PMID:[Spontaneous renal rupture due to xanthogranulomatous pyelonephritis; a case report]. 868 83

Xanthogranulomatous pyelonephritis is an uncommon variant of chronic pyelonephritis that predominantly affects middle-aged women. Patients usually present with fever, back or flank pain, flank mass, and the constitutional symptoms of fatigue, malaise, weight loss, and anorexia. Rarely, they may present with a draining sinus. There is usually a history of urinary tract infection, obstruction, or instrumentation. Other abnormalities include anemia, leukocytosis, abnormal liver enzymes, pyuria, and hematuria. Mild azotemia may be present, but frank renal failure is rare. Urine and renal tissue cultures are frequently positive. The most commonly isolated bacterial pathogens are P. mirabilis and E. coli, but other organisms have also been implicated. A CT scan is the best radiologic imaging technique to discover the extent of inflammation as well as any involvement of adjacent structures. Lipid-laden macrophages called xanthoma cells characterize the disease at the microscopic level. Nephrectomy is curative. Careful preoperative evaluation will guide surgical planning in choosing an approach that provides adequate exposure of the affected tissue and facilitates subsequent care of the patient.
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PMID:A middle-aged woman with back and flank pain. 881 29

Xanthogranulomatous pyelonephritis (XGP) is a specific form of chronic inflammatory kidney disease which may involve both sexes at any age. The disease presents either in the diffuse form or less commonly as a focal process which is almost impossible to differentiate from renal malignancy. XGP usually occurs in association with urinary tract obstruction, infection and/or renal stones. Symptoms are often vague and non-specific. The most common offending organisms are E. coli and Proteus mirabilis. In reviewing the literature we have found 197 cases in children during the last thirty years, and of these only 15 (7.6%) were of the focal form. A case of focal xanthogranulomatous pyelonephritis in a 6-year-old boy is reported which demonstrates the diagnostic difficulties encountered in this disease. We emphasize the importance of XGP in the differential diagnosis of renal tumours in children with recurrent or therapy-resistant urinary tract infection in spite of no evidence of renal stone, poorly or absent function in the kidney or urinary tract obstruction.
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PMID:Focal xanthogranulomatous pyelonephritis presenting as renal tumour in children. Case report with a review of the literature. 883 58

Xanthogranulomatous pyelonephritis (XGP) is an uncommon form of pyelonephritis rarely seen in children. It is characterized by destruction of the renal parenchyma and invasion of adjacent tissues, mimicking renal tumors. Preoperative diagnosis is very difficult. Two children with XGP are presented. One underwent nephrectomy and the other drainage of a renal abscess with kidney preservation. Although surgery is considered the only effective treatment, a high index of suspicion and renal biopsy may prevent radical nephrectomy.
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PMID:Xanthogranulomatous pyelonephritis mimicking malignant disease: is preservation of the kidney possible? 923 26

Xanthogranulomatous pyelonephritis rarely occurs in renal allografts. This is the fifth reported case. Diagnosis was made by renal biopsy, which is usually performed to evaluate an elevated serum creatinine. Associated patient symptomology is nonspecific, and graft imaging with ultrasonography and computed tomography was not helpful as it would be with native kidney xanthogranulomatous pyelonephritis. Successful treatment with antibiotics may depend on the serum creatinine at presentation. Prognosis, therefore, is guarded, with a common outcome of irreversible renal dysfunction.
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PMID:Xanthogranulomatous pyelonephritis in a renal allograft recipient. 939 31

Xanthogranulomatous pyelonephritis is a morphologic variant of pyelonephritis. Focal disease is very rare and can be misdiagnosed.
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PMID:Misleading leads: focal xanthogranulomatous pyelonephritis in childhood. 940 22


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