RESUMO
La pielonefritis xantogranulomatosa es una enfermedad inflamatoria muy poco frecuente, que se caracteriza por la sustitución del parénquima renal por tejido granulomatoso. Su presentación se caracteriza por dolor abdominal y síntomas constitucionales asociados a infecciones de orina de repetición. Los gérmenes más frecuentemente implicados son Escherichia coli y Proteus mirabilis. El diagnóstico definitivo es anatomopatológico y el único tratamiento curativo es la nefrectomía total o parcial. Presentamos una actualización de los conocimientos de esta enfermedad a raíz de un caso recientemente diagnosticado en nuestro servicio
Xanthogranulomatous pyelonephritis is a rare inflammatory disease, characterized by replacement of renal parenchyma with granulomatous tissue. Initial clinical presentation includes abdominal pain and constitutional symptoms related to recurrent urinary infections. The microorganisms most commonly involved are Escherichia coli and Proteus mirabilis. Final diagnosis is made by histopathology, and the only curative treatment is total or partial nephrectomy. A recently diagnosed case in our unit is presented, as well as an update on the knowledge of this disease
Assuntos
Humanos , Feminino , Criança , Pielonefrite Xantogranulomatosa/congênito , Pielonefrite Xantogranulomatosa/complicações , Pielonefrite Xantogranulomatosa/diagnóstico , Pielonefrite Xantogranulomatosa/metabolismo , Anorexia/complicações , Anorexia/dietoterapia , Infecções Urinárias/diagnóstico , Pielonefrite Xantogranulomatosa/induzido quimicamente , Pielonefrite Xantogranulomatosa/mortalidade , Pielonefrite Xantogranulomatosa/patologia , Anorexia/metabolismo , Anorexia/prevenção & controle , Infecções Urinárias/complicações , Infecções Urinárias/urina , Abscesso/complicaçõesRESUMO
A 2-month-old infant died of xanthogranulomatous pyelonephritis. Preoperatively pyonephrosis was suspected, because the child presented with a number of inflammatory, septic symptoms. Nephrectomy was performed and histopathology showed the kidney to be affected by xanthogranulomatous pyelonephritis. Postoperatively the child developed persistent attacks of fever and bronchopneumonia that led to his death with signs of pulmonary insufficiency.
Assuntos
Hidronefrose/congênito , Doenças Renais Policísticas/congênito , Pielonefrite Xantogranulomatosa/congênito , Obstrução Ureteral/congênito , Humanos , Hidronefrose/patologia , Lactente , Rim/patologia , Masculino , Nefrectomia , Doenças Renais Policísticas/patologia , Pielonefrite Xantogranulomatosa/patologia , Ureter/patologia , Obstrução Ureteral/patologiaRESUMO
The authors describe a rare case of this disease that has clinically manifested in a 12-days-old boy. At the age of 1.5 months a right-side nephrectomy for a supposed Wilms' tumor has been performed. Histologic examination has diagnosed congenital xanthogranulomatous pyelonephritis. The authors put forward a hypothesis on the existence of primary forms of this condition not associated with persistent infections or urinary tract obstructions.