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Renal parenchymal malakoplakia in a four-week-old infant
Insights
This case study reports on the youngest infant diagnosed with malakoplakia, a rare condition affecting the kidneys. Steroid therapy showed significant improvement in the infant
Area of Science:
- Pediatric Nephrology
- Rare Diseases
- Infectious Diseases
Background:
- Malakoplakia is a rare acquired condition characterized by the presence of Michaelis-Gutmann bodies.
- It typically affects the genitourinary tract but can occur in other organs.
- Renal parenchymal malakoplakia is exceptionally rare, especially in infants.
Observation:
- A four-week-old male infant presented with fever, convulsions, and lethargy.
- Clinical findings included anemia, hepatosplenomegaly, bilateral nephromegaly, and impaired renal function.
- Escherichia coli was identified in blood and urine cultures.
Findings:
- Kidney biopsy confirmed bilateral renal parenchymal malakoplakia.
- Intravenous methylprednisolone pulse therapy was administered.
- The infant showed significant clinical improvement following treatment.
Implications:
- This case highlights the youngest patient reported with malakoplakia.
- Steroid therapy may be beneficial in treating renal parenchymal malakoplakia, even without underlying systemic disease.
- Early diagnosis and treatment are crucial for favorable outcomes in pediatric patients.
Abstract:
We describe a four-week-old male infant with bilateral renal parenchymal malakoplakia who presented with low grade fever, convulsions and lethargy. The patient had profound anemia, hepatosplenomegaly and bilateral nephromegaly with reduced renal function. Both blood and urine cultures grew Escherichia coli, and antibiotic therapy was started. A kidney biopsy obtained on the 20th hospital day confirmed the diagnosis of renal parenchymal malakoplakia. Following treatment with an intravenous methylprednisolone pulse therapy, the infant made significant clinical improvement. He has grown and developed normally in the three years following this episode. We suggest that the steroid therapy was useful in ameliorating renal parenchymal malakoplakia in a patient without an underlying systemic disease. This report describes the youngest patient to have malakoplakia.