Bear Paw Sign: Xanthogranulomatous Pyelonephritis.

Area of Science:

• Nephrology
• Pathology

Background:

• Xanthogranulomatous pyelonephritis (XGP) is a rare, destructive inflammatory kidney disease.
• Typically affects immunocompromised middle-aged females with risk factors like ureteral obstruction or chronic urinary tract infections (UTIs).
• Often associated with the formation of renal calculi (kidney stones).

Observation:

• Presents a case of a 44-year-old female with a history of left kidney staghorn calculi and recurrent UTIs.
• Abdominal computed tomography (CT) revealed the characteristic 'bear paw' sign, indicative of XGP.
• The patient underwent a nephrectomy for the condition.

Findings:

• The 'bear paw' sign on CT is a key diagnostic indicator for XGP.
• Surgical intervention (nephrectomy) was effective in managing this case of XGP.
• The patient experienced an uneventful post-operative recovery.

Implications:

• This case underscores the importance of recognizing the 'bear paw' sign for early XGP diagnosis.
• Highlights the successful surgical management of XGP, even in complex cases involving staghorn calculi.
• Contributes to the understanding of XGP presentation and treatment in middle-aged women.