Atypical presentation of xanthogranulomatous pyelonephritis: a case report.

Xanthogranulomatous pyelonephritis (XPN) is a rare form of chronic pyelonephritis, which is usually caused by calculous obstructive uropathy. We present a previously healthy 45-year-old housewife, who was admitted to The Dammam Central Hospital, Dammam, Saudi Arabia with left loin pain and increased frequency of micturition of four days duration. She also had icterus and features of disseminated intravascular coagulation. Abdominal ultrasound and computed tomography of the abdomen was suggestive of XPN. She responded well to treatment with antibiotics and nephrectomy. Histology of the resected kidney confirmed a diagnosis of XPN. Our case suggests that the diagnosis of XPN should be kept in mind when a middle-aged female patient presents with unilateral non-functioning hydronephrotic kidney, which is totally distorted, and has enhancing as well as non-enhancing regions on computed tomography.

Atypical presentation of Churg-Strauss syndrome: another "forme fruste" of the disease?

Vasculitis is a clinicopathologic process characterized by inflammation and damage to blood vessels. A broad and heterogenous group of syndromes may result from this process, because any type, size, and location of blood vessel may be involved. The cause of these conditions remains unclear, but an autoimmune inflammatory process, characterized by involvement of both neutrophils and endothelial cells, seems to play an important role. In 1951, Churg and Strauss described a clinical syndrome of severe asthma, hypereosinophilia with eosinophilic infiltrates, eosinophilic vasculitis, and granulomata in various organs. Asthma may precede this vasculitis by many years. We report a case of anti-neutrophil cytoplasmic antibody-positive, pauci-immune, crescentic, necrotizing glomerulonephritis with peripheral and interstitial eosinophilia but without asthma. This is very unusual in Churg-Strauss syndrome.

[Renal puncture biopsy in nephrotic syndrome in Cameroonian children, adolescent and adults: histopathologic profile according to age]. / Ponctions-biopsies rénales au cours du syndrome néphrotique de l'enfant, du jeune et de l'adulte camerounais: profile histopathologique selon l'âge.

Eighty-six renal biopsies were under-taken in the Nephrology Service of the Yaounde Central Hospital (Cameroon, Central Africa) during a 4 year period (1st January 1986 to 31st of December 1989). Fifty of them (58%) were done in case of nephrotic syndrome associated or not with hypertension, renal failure. Only 42 of these 50 biopsies were valid and concerned 9 patients aged 8 to 15 years, 22 aged 16 to 30 years and 11 above 30 years. On the whole, 3 main lesions were noted: minimal changes (16 cases: 38.4%), membranous glomerulonephritis (13 cases: 31.2%) and proliferative glomerulonephritis (10 cases: 24%). From the analysis of lesions observed in each age group, it was found that the histopathologic profile of renal biopsies during nephrotic syndrome is practically identical in cameroonian children, young and adults with a relative predominance of minimal change and various glomerular lesions regardless of the age group.