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Xanthogranulomatous pyelonephritis in pediatric patients
G J Matthews1, G A McLorie, B A Churchill
1Hospital for Sick Children, Toronto, Ontario, Canada.
The Journal of Urology
|June 1, 1995
Summary
Xanthogranulomatous pyelonephritis (XGP) was found in 18.5% of nephrectomies for end-stage pyelonephritis. This condition may be more common than previously thought, especially in pediatric cases.
Area of Science:
- Nephrology
- Pediatric Pathology
- Urologic Oncology
Background:
- Xanthogranulomatous pyelonephritis (XGP) is a rare, chronic suppurative bacterial infection of the kidney.
- It is often associated with obstruction and infection, but its true incidence and presentation, particularly in children, are not well-defined.
Purpose of the Study:
- To determine the incidence of XGP in pediatric patients undergoing nephrectomy for end-stage pyelonephritis.
- To compare the clinical and pathological presentation of XGP in pediatric versus adult populations.
- To highlight the under-diagnosis of XGP in prospective evaluations.
Main Methods:
- Retrospective review of 27 nephrectomies performed for end-stage pyelonephritis.
- Analysis of clinical histories, pathological findings, and prospective diagnostic accuracy.
- Comparison of pediatric cases with existing literature on adult XGP.
Main Results:
- Xanthogranulomatous pyelonephritis (XGP) was identified in 5 out of 27 (18.5%) nephrectomies.
- Two pediatric patients, under 5 months old, presented with XGP.
- Prospective diagnosis of XGP was made in only one case, despite consistent clinical and pathological findings.
Conclusions:
- Xanthogranulomatous pyelonephritis (XGP) may be more prevalent than previously reported, especially in pediatric end-stage renal disease.
- The clinical and pathological features of XGP in children are similar to those in adults.
- Reevaluation of the incidence and chronicity of XGP is warranted based on current data.