Xanthogranulomatous pyelonephritis: Analysis of 18 cases
Xanthogranulomatous pyelonephritis: Analysis of 18 cases
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DOI：
10.1016/s1015-9584(09)60099-3
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发表时间：
2006-10-01
影响因子：
3.5
通讯作者：
Khader, Yousef Saleh
中科院分区：
文献类型：
--
作者：
Al-Ghazo, Mohammed Ahmed;Ghalayini, Ibrahim Fathi;Khader, Yousef Saleh
目的：回顾和评价临床病理诊断为黄色肉芽肿性肾盂肾炎（XGP）的患者，重点是诊断方法和社会经济地位对疾病严重程度的影响。方法：对患者既往病史、临床、实验室、放射影像学表现、术前、手术、组织病理学诊断和术后随访期间的数据进行分析。结果：18例XGP患者中，18例为单纯型XGP，1例为复杂型XGP。临床特征包括：尿路结石或梗阻、肾脏损害、合并尿路感染、贫血、红细胞沉降率增高和肝功能损害。所有患者均有弥漫性XGP。33.3%的病例有腰肌脓肿、肾皮瘘、肾结肠瘘、肾旁脓肿等并发症。接受计算机断层扫描（CT）评估的14名患者中有11名（78.6%）在肾切除术前做出了正确的诊断。88.9%的患者尿培养阳性，奇异变形杆菌是最常见的organis.CONCLUSION：我们的经验与少数患者表明，低社会经济地位可能是一个危险因素，在复杂的情况下XGP的发展。CT被认为是术前正确诊断和评估XGP的最佳放射学检查。肾切除术和切除所有周围受影响的组织被证明是治愈XGP。
OBJECTIVE: To review and evaluate patients with a clinicopathological diagnosis of xanthogranulomatous pyelonephritis (XGP) with emphasis on the diagnostic methods and the effect of socioeconomic status on disease severity.METHODS: Data compiled from the previous history of the patients, clinical, laboratory, radioimaging findings, preoperarive, operative, histopathological diagnosis and postoperative follow-up period were analysed. On the basis of presentation, XGP was classified as complicated and simple.RESULTS: There were 18 cases of XGP. The clinical characteristics included: calculi or obstruction in the urinary tract, and damage to the kidney, complication of urinary tract infection, anaemia, increased erythrocyte sedimentation rate and liver dysfunction. All patients had diffuse XGP. Associated pathological findings such as psoas abscess, nephrocutaneous fistula, renocolonic fistula and paranephric abscess were found in 33.3% of cases. Eleven of 14 patients (78.6%) who were evaluated by computed tomography (CT) had the correct diagnosis made prior to nephrectomy. Urine culture was positive in 88.9% of patients and Proteus mirabilis was the most common organism.CONCLUSION: Our experience with a small number of patients demonstrates that low socioeconomic status could be a risk factor in the development of complicated cases of XGP. CT is considered to be the best radiological test for correct preoperative diagnosis and evaluation of XGP. Nephrectomy and removal of all surrounding affected tissue proved to be curative for XGP.