Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review

ABSTRACT Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, often associated with renal calculus and infection Escherichia coli and Proteus mirabilis are the most frequent organisms isolated in individuals with the disease. Its incidence is 1.4 cases per 100,000 popul...

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Main Authors: Orgeness Jasper Mbwambo, Nelton Rodrick Thobias, Alex Mremi, Jasper Saidi Mbwambo, Frank Bright, Bartholomeo Nicholaus Ngowi
Format: Article
Language:English
Published: Wiley 2025-08-01
Series:Clinical Case Reports
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Online Access:https://doi.org/10.1002/ccr3.70774
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author Orgeness Jasper Mbwambo
Nelton Rodrick Thobias
Alex Mremi
Jasper Saidi Mbwambo
Frank Bright
Bartholomeo Nicholaus Ngowi
author_facet Orgeness Jasper Mbwambo
Nelton Rodrick Thobias
Alex Mremi
Jasper Saidi Mbwambo
Frank Bright
Bartholomeo Nicholaus Ngowi
author_sort Orgeness Jasper Mbwambo
collection DOAJ
description ABSTRACT Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, often associated with renal calculus and infection Escherichia coli and Proteus mirabilis are the most frequent organisms isolated in individuals with the disease. Its incidence is 1.4 cases per 100,000 population each year. We present a case of a 69‐year‐old woman who presented with abdominal pain, icterus, fever, non‐projectile vomiting, anemia, and recurrent urinary tract infections. A diagnosis of nephrolithiasis was made and the patient was started on empirical antibiotics. An abdominal pelvic CT scan was performed that showed features suggestive of XGP; a nephrectomy was performed, and a tissue biopsy was taken for histopathology and the results confirmed a diagnosis of XGP. XGP diagnosis is extremely challenging due to its ability to mimic other renal pathologies, and a high degree of suspicion is required. Abdominal pelvic ultrasound is helpful in preoperative diagnosis and a biopsy postoperatively is required to confirm XGP diagnosis. Medical management of XGP with antibiotics and nephrectomy is the best treatment option.
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issn 2050-0904
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publishDate 2025-08-01
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series Clinical Case Reports
spelling doaj-art-e4c0511bd46c4e4f964909860803faab2025-08-22T07:33:08ZengWileyClinical Case Reports2050-09042025-08-01138n/an/a10.1002/ccr3.70774Xanthogranulomatous Pyelonephritis: A Case Report and Literature ReviewOrgeness Jasper Mbwambo0Nelton Rodrick Thobias1Alex Mremi2Jasper Saidi Mbwambo3Frank Bright4Bartholomeo Nicholaus Ngowi5Department of Urology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaDepartment of Urology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaDepartment of Pathology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaDepartment of Urology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaDepartment of Urology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaDepartment of Urology, Faculty of Medicine Kilimanjaro Christian Medical University College Moshi TanzaniaABSTRACT Xanthogranulomatous pyelonephritis (XGP) is a rare form of chronic pyelonephritis, often associated with renal calculus and infection Escherichia coli and Proteus mirabilis are the most frequent organisms isolated in individuals with the disease. Its incidence is 1.4 cases per 100,000 population each year. We present a case of a 69‐year‐old woman who presented with abdominal pain, icterus, fever, non‐projectile vomiting, anemia, and recurrent urinary tract infections. A diagnosis of nephrolithiasis was made and the patient was started on empirical antibiotics. An abdominal pelvic CT scan was performed that showed features suggestive of XGP; a nephrectomy was performed, and a tissue biopsy was taken for histopathology and the results confirmed a diagnosis of XGP. XGP diagnosis is extremely challenging due to its ability to mimic other renal pathologies, and a high degree of suspicion is required. Abdominal pelvic ultrasound is helpful in preoperative diagnosis and a biopsy postoperatively is required to confirm XGP diagnosis. Medical management of XGP with antibiotics and nephrectomy is the best treatment option.https://doi.org/10.1002/ccr3.70774chronic pyelonephritislipid‐laden macrophagesnecrotizing inflammationurinary tract infectionxanthogranulomatous pyelonephritis
spellingShingle Orgeness Jasper Mbwambo
Nelton Rodrick Thobias
Alex Mremi
Jasper Saidi Mbwambo
Frank Bright
Bartholomeo Nicholaus Ngowi
Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
Clinical Case Reports
chronic pyelonephritis
lipid‐laden macrophages
necrotizing inflammation
urinary tract infection
xanthogranulomatous pyelonephritis
title Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
title_full Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
title_fullStr Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
title_full_unstemmed Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
title_short Xanthogranulomatous Pyelonephritis: A Case Report and Literature Review
title_sort xanthogranulomatous pyelonephritis a case report and literature review
topic chronic pyelonephritis
lipid‐laden macrophages
necrotizing inflammation
urinary tract infection
xanthogranulomatous pyelonephritis
url https://doi.org/10.1002/ccr3.70774
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