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Xanthogranulomatous pyelonephritis in nonfunctioning transplanted kidney.

S Kaplan-Pavlovcic1, A Kmetec, A Vizjak

  • 1Department of Nephrology, University Medical Centre, Zaloska 7, SI-1000 Ljubljana, Slovenia. stasa.kaplan@kclj.si

Transplantation Proceedings
|December 31, 2003
PubMed
Summary

Xanthogranulomatous pyelonephritis is a rare, severe kidney infection. In kidney transplant patients, it presents as fever in a nonfunctioning graft and requires histologic evaluation for diagnosis.

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Area of Science:

  • Nephrology
  • Pathology
  • Infectious Disease

Background:

  • Xanthogranulomatous pyelonephritis (XGP) is a rare, severe chronic infection of the renal parenchyma, affecting both native and allografted kidneys.
  • Diagnosis in native kidneys can sometimes be achieved with imaging like ultrasonography and computed tomography.
  • In renal allografts, definitive diagnosis typically requires histologic evaluation of transplant biopsies or nephrectomy specimens.

Observation:

  • This report details a febrile patient with a failing renal allograft.
  • Xanthogranulomatous pyelonephritis was diagnosed through histologic examination of the transplantectomy specimen.
  • This case highlights a specific clinical presentation in a post-transplant setting.

Findings:

  • Histologic evaluation confirmed xanthogranulomatous pyelonephritis in a nonfunctioning renal allograft.

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  • Imaging modalities may not be sufficient for diagnosing XGP in allografted kidneys.
  • The case underscores the importance of histological analysis for rare renal pathologies.

    • Implications:

    • Xanthogranulomatous pyelonephritis should be considered in the differential diagnosis for febrile patients with nonfunctioning renal transplants.
    • Early consideration of XGP can aid in timely and accurate diagnosis in transplant recipients.
    • This finding contributes to the understanding of infectious complications in renal transplantation.