Ayad Anass, Ettouhami Badr, Thami Benouachane, Bentahila Abdelali
Service de Pédiatrie 4, Hôpital d'Enfants de Rabat, Maroc.
Pan Afr Med J. 2017 May 8;27:17. doi: 10.11604/pamj.2017.27.17.12225. eCollection 2017.
Xanthogranulomatous pyelonephritis (XGP) is a chronic pyelonephritis observed in children and exceptionally in infants. Symptomatology is vague and may delay diagnosis and patient's management. Treatment is based on medical therapy but most often on surgery with poor renal prognosis. We report the case of a 15-month old infant with isolated mass in the left flank. He had no fever or alteration of general state and urine cultures were sterile. Radiological evaluation (renal ultrasound, uroscan and renal scintigraphy) highlighted left non-functioning kidney with "hydropyonephrosis" evoking the diagnosis of XGP. The indication for total nephrectomy by lombotomy was posed and definitive anatomo-pathological examination confirmed the diagnosis of diffuse XGP. This observation emphasizes the importance of suspect PXG in patients with renal mass or malformative uropathy with recurrent urinary tract infections whose treatment should be rigorous and codified.
黄色肉芽肿性肾盂肾炎(XGP)是一种在儿童中观察到的慢性肾盂肾炎,在婴儿中极为罕见。症状不明确,可能会延迟诊断和患者的治疗。治疗以药物治疗为主,但大多数情况下需进行手术,肾脏预后较差。我们报告一例15个月大的婴儿,左侧腰部有孤立性肿块。他没有发热或全身状况改变,尿培养无菌。影像学评估(肾脏超声、尿路造影和肾脏闪烁扫描)显示左肾无功能伴“脓性肾盂积水”,提示XGP诊断。通过腰部切口进行全肾切除术的指征明确,最终的解剖病理学检查证实为弥漫性XGP诊断。该病例强调了在患有肾脏肿块或畸形性泌尿系统疾病且反复发生尿路感染的患者中怀疑PXG的重要性,其治疗应严格且规范。