Osca J M, Peiro M J, Rodrigo M, Martinez-Jabaloyas J M, Jimenez-Cruz J F
Department of Urology, University Hospital La Fe, Valencia, Spain.
Eur Urol. 1997;32(3):375-9.
We report 11 cases of focal xanthogranulomatous pyelonephritis (FXGP), a disease that is very uncommon. The aim of the present work is to assess the effectivity of conservative treatment.
Eleven of the 82 cases of XGP (12.5%) diagnosed between 1970 and 1995 presented the focal form (FXGF). Clinical features, laboratory findings, radiological imaging studies, surgical treatment and follow-up were evaluated.
FXGP occurred in middle-aged women (female/male ratio 4.5:1) who had a history of calculosis, urinary infections produced by Escherichia coli and Proteus mirabilis, or urinary tract abnormalities. FXGP was unilateral in all cases. The most frequent symptom was flank pain. Some hematological and biochemical parameters were altered. Intravenous urography and sonography revealed calculosis, hydronephrosis or renal mass, but these findings are nonspecific. Only abdominal CT scan can establish the correct diagnosis. Five of these patients (45.5%) underwent partial nephrectomy at our hospital. During the follow-up, patients showed no relapse in the ipsilateral or contralateral kidney. Serum parameters were in normal range.
When FXGP is diagnosed, local excision is recommended in all cases, since relapse in the affected kidney is unusual.
我们报告了11例局灶性黄色肉芽肿性肾盂肾炎（FXGP），这是一种非常罕见的疾病。本研究的目的是评估保守治疗的有效性。
1970年至1995年间诊断的82例XGP病例中有11例（12.5%）表现为局灶性形式（FXGF）。对临床特征、实验室检查结果、放射影像学研究、手术治疗及随访情况进行了评估。
FXGP发生于中年女性（男女比例为4.5:1），她们有结石病史、由大肠杆菌和奇异变形杆菌引起的泌尿系统感染或尿路异常。所有病例均为单侧发病。最常见的症状是胁腹痛。一些血液学和生化参数发生了改变。静脉肾盂造影和超声检查显示有结石、肾积水或肾肿块，但这些表现均不具有特异性。只有腹部CT扫描才能做出正确诊断。其中5例患者（45.5%）在我院接受了部分肾切除术。在随访期间，患者同侧或对侧肾脏均未复发。血清参数在正常范围内。
当诊断为FXGP时，建议所有病例均行局部切除，因为患肾复发并不常见。
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