Kakumani Jagadeswar, Koduri Amukthamalyada, Lankapothu Prem Balaji Reddy, Kumar S Magesh
Internal Medicine, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
General Medicine, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND.
Cureus. 2024 Sep 10;16(9):e69097. doi: 10.7759/cureus.69097. eCollection 2024 Sep.
Xanthogranulomatous pyelonephritis (XGP) and Plummer-Vinson Syndrome (PVS) are two rare disorders that pose considerable diagnostic difficulties mainly because their signs overlap and are multifaceted. XGP is a severe form of pyelonephritis imitating cancer, whereas PVS is defined by dysphagia, iron deficiency anemia, and esophageal webs. This article presents the case of a 53-year-old female with a previous history of renal calculi and multiple transfusions who presented with dysphagia, flank pain, and hematuria. Findings from investigations showed severe anemia, a renal lesion suggesting malignancy, and GI findings pointing to the presence of PVS. The coexistence of XGP and PVS in this patient highlights the need for careful differential diagnosis and the importance of a multidisciplinary approach in managing patients with rare overlapping syndromes. Furthermore, this example shows how chronic infection, malnutrition, and their potential for leading to neoplasms connect. In summary, one should recognize that the possibility these two conditions can coincide is paramount for accurate diagnosis and effective management. Lastly, this case demonstrates that comprehensive assessment can only be achieved through coordinated care addressing both direct effects as well as secondary complications due to such uncommon diseases.
黄色肉芽肿性肾盂肾炎(XGP)和普卢默-文森综合征(PVS)是两种罕见疾病,主要因其症状重叠且具有多面性而给诊断带来相当大的困难。XGP是一种类似癌症的严重肾盂肾炎形式,而PVS的定义为吞咽困难、缺铁性贫血和食管蹼。本文介绍了一名53岁女性的病例,该女性既往有肾结石病史且多次输血,出现了吞咽困难、侧腹痛和血尿。检查结果显示严重贫血、提示恶性肿瘤的肾脏病变以及提示存在PVS的胃肠道检查结果。该患者同时存在XGP和PVS,凸显了仔细鉴别诊断的必要性以及多学科方法在管理罕见重叠综合征患者中的重要性。此外,这个例子展示了慢性感染、营养不良及其导致肿瘤的可能性之间的联系。总之,认识到这两种情况可能同时存在对于准确诊断和有效管理至关重要。最后,该病例表明,只有通过协调护理来解决此类罕见疾病的直接影响以及继发并发症,才能实现全面评估。