2007, Number 2
Pielonefritis xantogranulomatosa. Experiencia en el Hospital General “Dr. Manuel Gea González” y revisión de la literatura
Leos C, Shuck C, Camarena H, Vázquez L, Cantellano M, Andrade D, Fernández A, Lamm L, Márquez JC, Pacheco C, Morales G, Parraguirre S, Calderón F
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Language: Spanish
References: 16
Page: 81-85
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ABSTRACT
Xanthogranulomatous pyelonephritis is a very uncommon, chronic and severe infectious entity; it generally presents with diffuse renal destruction, and it’s associated with lithiasis and chronic infection.General objective. The 17 years of experience in xanthogranulomatous pyelonephritis at Hospital General “Dr. Manuel Gea Gonzalez” is presented in this study.
Specific objective. To show the direct relation between xanthogranulomatous pyelonephritis, lithiasis, chronic infection and diabetes.
Material and methods. The clinic files of all patients that underwent nephrectomy in a period between september of 1989 and july of 2006 were reviewed. Xanthogranulomatous pyelonephritis cases were identified. The relation with lithiasis, chronic infection and diabetes mellitus was also identified. All cancer patients were excluded of this study.
Results. 148 clinical files patients that underwent to nephrectomy in 17 years were reviewed; 82 patients with renal cancer were excluded from the study. Of the 66 patients left, 32 (47.7%) had chronic pyelonephritis, three (4.4%) renal tuberculosis, one renal abscess (1.5%), two by renal trauma (3%) and two had nefrocalcinosis (3%); 25 (38.8%) had histopathologic diagnose of xanthogranulomatous pyelonephritis [22 (84%) were female and 3 (16%) were male); the mean age of presentation was 43.2 years (range 20-68 years); 96% (24 patients) had association with lithiasis; 32% (eight patients) had diabetes mellitus and 96% had renal exclusion at the time of the surgery.
Discussion. Xanthogranulomatous pyelonephritis is a very uncommon, chronic and severe infectious entity; it has an incidence from 0.6 to 1.4% of the kidneys extirpated by inflammation, being related to chronic lithiasis and inflammatory processes and in some occasions to mycosis and cancer.
Conclusions: World-wide literature reports that the incidence of xanthogranulomatous pyelonephritis is very low. In our institution, this cases occurs greater than tuberculosis, abscesses and renal trauma cases, corresponding to almost 40% of the kidneys extirpated by inflammation, having a 32% relation with diabetes, and 96% with lithiasis.
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