Xanthogranulomatous Pyelonephritis in a Socioeconomically Disadvantaged Immigrant Child: A Case Report

Area of Science:

• Nephrology
• Pediatric Nephrology
• Pathology

Background:

• Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic inflammatory kidney disease.
• It is characterized by renal parenchyma destruction, often linked to obstructive uropathy and kidney stones.
• XGP is particularly uncommon in children and can be misdiagnosed as malignancy or other renal infections.

Purpose of the Study:

• To present a case of advanced XGP in a pediatric patient with limited healthcare access.
• To highlight the diagnostic challenges and potential severity of delayed management in XGP.
• To emphasize the importance of considering XGP in children with specific symptoms and risk factors.

Main Methods:

• Case report of a 13-year-old girl with Xanthogranulomatous pyelonephritis.
• Clinical presentation, imaging (revealing a non-functioning, enlarged kidney with staghorn calculi), and laboratory findings.
• Histopathological examination confirming XGP and stone analysis.

Main Results:

• The patient presented with prolonged fever, flank pain, weight loss, and fatigue.
• Despite initial treatment, her condition progressed, requiring nephrectomy.
• Histopathology confirmed XGP, and stone analysis indicated chronic infection-related calculi.

Conclusions:

• Delayed diagnosis and management of XGP, especially in socioeconomically disadvantaged populations, can lead to severe renal damage.
• Clinicians should suspect XGP in pediatric patients with recurrent UTIs, renal calculi, and nonspecific systemic symptoms.
• Early recognition and multidisciplinary surgical intervention are vital for preventing irreversible kidney damage and reducing morbidity.