Malakoplakia after kidney transplantation: Case report and literature review

Area of Science:

• Urology
• Transplantation Medicine
• Pathology

Background:

• Malakoplakia is a rare granulomatous condition often linked to infections, primarily affecting the urinary tract.
• It frequently manifests as recurrent urinary tract infections (r-UTI) and can lead to impaired renal function.
• Immunosuppression, particularly in solid organ transplantation (SOT) recipients like kidney transplant patients, is a significant associated factor.

Observation:

• Macroscopic presentation can mimic neoplasia, underscoring the diagnostic importance of histology.
• A case of bladder malakoplakia in a renal transplant patient presented as an Escherichia coli r-UTI.
• This case was refractory to prolonged antibiotic therapy and reduced immunosuppression.

Findings:

• Histological examination is crucial for definitive diagnosis, differentiating malakoplakia from malignancy.
• The presented case demonstrated treatment resistance to conventional medical management.
• Surgical intervention led to the resolution of bladder malakoplakia in the immunosuppressed patient.

Implications:

• This case highlights the challenges in managing malakoplakia in SOT recipients.
• It suggests that surgical management may be a viable option for refractory cases.
• Further research into optimal treatment strategies for malakoplakia in transplant populations is warranted.