PIELONEFRITIS XANTOGRANULOMATOSA

Abstract

Twenty-five cases of xanthogranulomatous pyelonephritis seen over a period of 7 years are presented with a marked predominance of females (7 to 1). Urinary tract infection was found in 21 cases, with E. coli (44%) predominating, followed by Proteus mirabilis (16%). Lithiasis was found in 15 cases, coraliform in 5 cases, pyelitic in 7 cases and ureteric in 3 cases. Radiologically the authors found an increase in renal size in 64%, renopsoas line erased in 72% and functional annulment in 88% of the cases. The condition was associated with adult diabetes in 10 cases (40%) and with hypertriglyceridemia in 8 cases. Eleven patients showed a dysfunction in at least 2 out of the 6 hepatic function tests carried out: E.S., alkaline phosphatase, prothrombin time, GOT, GPT and cholemia. In four cases biopsy was undertaken, the anatomopathological diagnosis being nonspecific reactive hepatitis. Total nephrectomy was carried out in 23 cases, and partial nephrectomy in 2 cases. The hepatic dysfunction disappeared and the biochemical parameters became normal in all patients.