Xanthogranulomatous pyelonephritis

Xanthogranulomatous pyelonephritis (XGP) is a rare form of pyelonephritis, a type of kidney disease. It is characterized by chronic inflammation of the renal parenchyma and the formation of granulomas and abscesses. XGP is often associated with urinary tract infections and kidney stones.

Etiology

The exact cause of XGP is unknown, but it is often associated with chronic urinary tract infections and kidney stones. The most common bacteria found in XGP are Escherichia coli and Proteus mirabilis.

Pathophysiology

In XGP, the kidney becomes enlarged and filled with yellowish, pus-filled abscesses. The disease can affect one or both kidneys. It can also spread to the surrounding tissues, causing perinephric abscesses and fistulas.

Clinical Presentation

Patients with XGP often present with symptoms of a urinary tract infection, such as fever, flank pain, and dysuria. They may also have hematuria, pyuria, and anemia. In severe cases, patients may present with weight loss, anorexia, and malaise.

Diagnosis

Diagnosis of XGP is often made based on clinical presentation and imaging studies. Ultrasound and computed tomography (CT) can show enlarged kidneys with multiple abscesses. A definitive diagnosis can be made with a biopsy of the kidney.

Treatment

Treatment of XGP usually involves antibiotics to treat the underlying infection and surgery to remove the affected kidney. In some cases, nephrectomy may be necessary.

Prognosis

The prognosis for XGP is generally good with treatment. However, if left untreated, the disease can lead to renal failure and other serious complications.

See Also

• Pyelonephritis
• Kidney disease
• Urinary tract infection
• Kidney stone

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