Ballentine William Keith, Vilson Fernandino, Dyer Raymond B, Mirzazadeh Majid
Department of Urology, Wake Forest Baptist Health, Medical Center Blvd, Winston-Salem, NC, 27157, USA.
Wake Forest School of Medicine, Winston-Salem, NC, 27157, USA.
BMC Urol. 2018 Jun 5;18(1):57. doi: 10.1186/s12894-018-0354-3.
Xanthogranulomatous pyelonephritis (XGP) is an uncommon infectious disease of the kidney known to mimic other renal maladies. A rare presentation of this uncommon disease is spontaneous renal hemorrhage (SRH).
We report a case of XGP in a 58 year old woman who presented with abdominal pain, hematuria, and radiating left flank pain. CT scan was felt to be consistent with perirenal hemorrhage abutting a fat-containing renal mass. The patient was eventually taken to surgery for left partial nephrectomy. Pathology report returned as XGP, and the patient has no complications from this disease process at 8 month follow up.
Our search of the literature shows XGP presenting as SRH to be a rare clinical entity. Furthermore, this is the first such case managed with a nephron-sparing approach. The "great imitator" XGP should be added to the differential for patients presenting with spontaneous renal hemorrhage.
黄色肉芽肿性肾盂肾炎（XGP）是一种罕见的肾脏感染性疾病，已知可模仿其他肾脏疾病。这种罕见疾病的一种罕见表现是自发性肾出血（SRH）。
我们报告一例58岁女性的XGP病例，该患者表现为腹痛、血尿和左侧腰部放射性疼痛。CT扫描显示与毗邻含脂肪肾肿块的肾周出血一致。患者最终接受了左肾部分切除术。病理报告为XGP，在8个月的随访中，患者没有出现该疾病过程的并发症。
我们对文献的检索显示，XGP表现为SRH是一种罕见的临床实体。此外，这是首例采用保留肾单位方法治疗的此类病例。对于出现自发性肾出血的患者，应将“伟大的模仿者”XGP纳入鉴别诊断。
