Hammadeh M Y, Nicholls G, Calder C J, Buick R G, Gornall P, Corkery J J
Department of Paediatric Surgery, Children's Hospital, Birmingham, UK.
Br J Urol. 1994 Jan;73(1):83-6. doi: 10.1111/j.1464-410x.1994.tb07461.x.
To diagnose xanthogranulomatous pyelonephritis (XGP) in childhood pre-operatively.
Eleven cases of XGP presenting to Birmingham Children's Hospital over a 10-year-period are reported. Nine (82%) were diagnosed preoperatively on the clinical and radiological findings.
The characteristic clinical findings were urinary tract infection (9 cases), palpable renal mass (8 cases) and anaemia (8 cases). The most common radiological findings were enlarged kidney (9 cases), renal calculi (7 cases) and non-functioning kidney (6 cases). Renal ultrasound typically demonstrated a central echoic area (6 cases) and multiple hypoechoic areas in the parenchyma (7 cases). A computed tomography (CT) scan was performed in three cases. This showed characteristic multiple, low attenuation, unenhanced areas within the parenchyma with extension of the inflammatory process into peri-nephric fat (two cases). Ten cases (91%) were of the diffuse type. There was extension into the peri-nephric fat in eight cases (73%). Three cases (27%) were associated with congenital urological abnormalities. Nephrectomy was performed in 10 cases and a partial nephrectomy in one.
XGP is uncommon in childhood but should always be considered in the differential diagnosis of renal masses, especially in the presence of anaemia. Nephrectomy usually results in a permanent cure.
术前诊断儿童黄色肉芽肿性肾盂肾炎（XGP）。
报告了10年间在伯明翰儿童医院就诊的11例XGP病例。9例（82%）根据临床和影像学检查结果在术前得到诊断。
典型的临床症状为尿路感染（9例）、可触及的肾肿块（8例）和贫血（8例）。最常见的影像学表现为肾脏增大（9例）、肾结石（7例）和无功能肾（6例）。肾脏超声检查通常显示中央回声区（6例）和实质内多个低回声区（7例）。3例行计算机断层扫描（CT）。其中2例显示实质内有特征性的多个低密度、未强化区域，炎症过程延伸至肾周脂肪。10例（91%）为弥漫型。8例（73%）炎症延伸至肾周脂肪。3例（27%）合并先天性泌尿系统异常。10例行肾切除术，1例行部分肾切除术。
XGP在儿童中并不常见，但在肾肿块的鉴别诊断中应始终予以考虑，尤其是伴有贫血时。肾切除术通常可实现根治。
