Case report: Xanthogranulomatous pyelonephritis successfully treated with antibiotics
Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has...
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| Published in | Urology case reports Vol. 57; p. 102840 |
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| Main Authors | , , , , |
| Format | Journal Article |
| Language | English |
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01.11.2024
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| Abstract | Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has been reported to be present in approximately 5% of all reported xanthogranulomatous cases. The clinical relevance of this disease is that it often mimics malignancy, and preoperative imaging is unable to differentiate between the two. Our case report demonstrated a renal lesion that mimicked malignancy and ultimately required histopathological examination for the diagnosis of XGP. Current consensus remains that surgery is the mainstay form of treatment. However, this case report showed that use of antibiotics alone can be successful as the patient showed significant improvement and resolution on interval imaging. |
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| AbstractList | Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has been reported to be present in approximately 5% of all reported xanthogranulomatous cases. The clinical relevance of this disease is that it often mimics malignancy, and preoperative imaging is unable to differentiate between the two. Our case report demonstrated a renal lesion that mimicked malignancy and ultimately required histopathological examination for the diagnosis of XGP. Current consensus remains that surgery is the mainstay form of treatment. However, this case report showed that use of antibiotics alone can be successful as the patient showed significant improvement and resolution on interval imaging. Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has been reported to be present in approximately 5% of all reported xanthogranulomatous cases. The clinical relevance of this disease is that it often mimics malignancy, and preoperative imaging is unable to differentiate between the two. Our case report demonstrated a renal lesion that mimicked malignancy and ultimately required histopathological examination for the diagnosis of XGP. Current consensus remains that surgery is the mainstay form of treatment. However, this case report showed that use of antibiotics alone can be successful as the patient showed significant improvement and resolution on interval imaging.Xanthogranulomatous inflammation (XGI) is an uncommon benign inflammatory disease process characterized by aggregation of lipid laden foamy macrophages, among other inflammatory cells. XGI affecting the kidney and renal pelvis is otherwise known as xanthogranulomatous pyelonephritis (XGP), which has been reported to be present in approximately 5% of all reported xanthogranulomatous cases. The clinical relevance of this disease is that it often mimics malignancy, and preoperative imaging is unable to differentiate between the two. Our case report demonstrated a renal lesion that mimicked malignancy and ultimately required histopathological examination for the diagnosis of XGP. Current consensus remains that surgery is the mainstay form of treatment. However, this case report showed that use of antibiotics alone can be successful as the patient showed significant improvement and resolution on interval imaging. |
| ArticleNumber | 102840 |
| Author | Wu, Bing Cheng Goh, Yen Seow Benjamin Chan, Ming Tow Thandapani, Karthik Thamboo, Thomas Paulraj |
| Author_xml | – sequence: 1 givenname: Ming Tow orcidid: 0000-0002-6522-5548 surname: Chan fullname: Chan, Ming Tow email: chanmingtow@hotmail.com organization: Department of Urology, National University Hospital, Singapore (5 Lower Kent Ridge Rd, Singapore 119074 – sequence: 2 givenname: Karthik surname: Thandapani fullname: Thandapani, Karthik email: karthik_thandapani@nuhs.edu.sg organization: Department of Urology, Ng Teng Fong General Hospital, Singapore (Jurong East Street 21, Singapore 609606 – sequence: 3 givenname: Bing Cheng surname: Wu fullname: Wu, Bing Cheng email: patwbc@nus.edu.sg organization: Department of Pathology, Ng Teng Fong General Hospital, Singapore (Jurong East Street 21, Singapore 609606 – sequence: 4 givenname: Thomas Paulraj surname: Thamboo fullname: Thamboo, Thomas Paulraj email: pattpt@nus.edu.sg organization: Department of Pathology, National University Hospital, Singapore (5 Lower Kent Ridge Rd, Singapore 119074 – sequence: 5 givenname: Yen Seow Benjamin surname: Goh fullname: Goh, Yen Seow Benjamin email: surgysb@nus.edu.sg organization: Department of Urology, National University Hospital, Singapore (5 Lower Kent Ridge Rd, Singapore 119074 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/39328902$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.it.2019.10.002 10.1161/ATVBAHA.111.226878 10.1016/S0022-5347(17)48937-3 10.3390/medicina57010032 10.1016/S1726-4901(09)70008-5 |
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| Keywords | Inflammation Xanthogranulomatous Antibiotics Pyelonephritis |
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| References | Jha, Aeddula (bib1) 2023 Ho, Wen, Chen (bib5) 2008; 71 El-Ghar, Farg, Sharaf, El-Diasty (bib4) 2021; 57 Allison, Cronstein (bib8) 2012; 32 Gaillard (bib3) 2022 Rasoulpour, Banco, Mackay, Hight, Berman (bib6) 1985; 133 Guerrini, Gennaro (bib7) 2019; 40 Jha, Aeddula (bib2) 2023; NIH Gaillard (10.1016/j.eucr.2024.102840_bib3) Jha (10.1016/j.eucr.2024.102840_bib1) 2023 Ho (10.1016/j.eucr.2024.102840_bib5) 2008; 71 Rasoulpour (10.1016/j.eucr.2024.102840_bib6) 1985; 133 El-Ghar (10.1016/j.eucr.2024.102840_bib4) 2021; 57 Guerrini (10.1016/j.eucr.2024.102840_bib7) 2019; 40 Jha (10.1016/j.eucr.2024.102840_bib2) 2023; NIH Allison (10.1016/j.eucr.2024.102840_bib8) 2012; 32 |
| References_xml | – volume: 32 start-page: 879 year: 2012 end-page: 886 ident: bib8 article-title: Regulation of foam cells by adenosine publication-title: Arterioscler Thromb Vasc Biol contributor: fullname: Cronstein – volume: 71 start-page: 643 year: 2008 end-page: 645 ident: bib5 article-title: Xanthogranulomatous pyelonephritis successfully treated with antibiotics only publication-title: J Chin Med Assoc contributor: fullname: Chen – year: 2023 ident: bib1 article-title: Xanthogranulomatous pyelonephritis - statpearls - NCBI bookshelf [Internet] publication-title: StatPearls contributor: fullname: Aeddula – year: 2022 ident: bib3 article-title: Xanthogranulomatous pyelonephritis | radiology reference article | Radiopaedia.org [internet]. Radiopaedia.org contributor: fullname: Gaillard – volume: 133 start-page: 345 year: 1985 ident: bib6 article-title: Treatment of focal xanthogranulomatous pyelonephritis with antibiotics publication-title: J Urol contributor: fullname: Berman – volume: NIH year: 2023 ident: bib2 article-title: Xanthogranulomatous pyelonephritis publication-title: StatPearls contributor: fullname: Aeddula – volume: 57 start-page: 32 year: 2021 ident: bib4 article-title: CT and MRI in urinary tract infections: a spectrum of different imaging findings publication-title: Medicina contributor: fullname: El-Diasty – volume: 40 start-page: 1163 year: 2019 end-page: 1179 ident: bib7 article-title: Foam cells: one size doesn't fit all publication-title: Trends Immunol contributor: fullname: Gennaro – volume: NIH year: 2023 ident: 10.1016/j.eucr.2024.102840_bib2 article-title: Xanthogranulomatous pyelonephritis publication-title: StatPearls contributor: fullname: Jha – volume: 40 start-page: 1163 issue: 12 year: 2019 ident: 10.1016/j.eucr.2024.102840_bib7 article-title: Foam cells: one size doesn't fit all publication-title: Trends Immunol doi: 10.1016/j.it.2019.10.002 contributor: fullname: Guerrini – ident: 10.1016/j.eucr.2024.102840_bib3 contributor: fullname: Gaillard – volume: 32 start-page: 879 year: 2012 ident: 10.1016/j.eucr.2024.102840_bib8 article-title: Regulation of foam cells by adenosine publication-title: Arterioscler Thromb Vasc Biol doi: 10.1161/ATVBAHA.111.226878 contributor: fullname: Allison – year: 2023 ident: 10.1016/j.eucr.2024.102840_bib1 article-title: Xanthogranulomatous pyelonephritis - statpearls - NCBI bookshelf [Internet] publication-title: StatPearls contributor: fullname: Jha – volume: 133 start-page: 345 issue: 2 year: 1985 ident: 10.1016/j.eucr.2024.102840_bib6 article-title: Treatment of focal xanthogranulomatous pyelonephritis with antibiotics publication-title: J Urol doi: 10.1016/S0022-5347(17)48937-3 contributor: fullname: Rasoulpour – volume: 57 start-page: 32 issue: 1 year: 2021 ident: 10.1016/j.eucr.2024.102840_bib4 article-title: CT and MRI in urinary tract infections: a spectrum of different imaging findings publication-title: Medicina doi: 10.3390/medicina57010032 contributor: fullname: El-Ghar – volume: 71 start-page: 643 issue: 12 year: 2008 ident: 10.1016/j.eucr.2024.102840_bib5 article-title: Xanthogranulomatous pyelonephritis successfully treated with antibiotics only publication-title: J Chin Med Assoc doi: 10.1016/S1726-4901(09)70008-5 contributor: fullname: Ho |
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| Title | Case report: Xanthogranulomatous pyelonephritis successfully treated with antibiotics |
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