Stoica I, et al. - The purpose of this research was to illustrate the outcomes of xanthogranulomatous pyelonephritis (XGP) in a paediatric cohort. The inclusion of XGP was recommended in the differential diagnosis of all children presenting with perirenal or psoas abscesses, renal masses and/or non-functioning kidneys with/or without associated urolithiasis. The findings revealed that clinical awareness and a high index of suspicion was warranted in order to achieve the correct pre-operative diagnosis and appropriate management.

Methods

• Data used for this research were the medical records of children who were diagnosed and treated for XGP at the current unit during the period 1963-2016.
• Information pertaining to each patient was recorded, with the inclusion of demographic data, past medical history, clinical and biochemical characteristics, diagnostic procedures, treatment methods, histopathologic diagnosis of the removed specimen, and outcome.

Results

• The eligible candidates constituted 66 children with a median age of 4.84 years (range 1.1-14.81), with an M:F ratio 1.35:1 underwent nephrectomy for XGP and had a median follow-up of 7.19 years (range 0.11-17.45).
• Systemic illness (62.1%), pain (60.6%), urinary tract infections (54.5%) and an abdominal mass (39.4%) were found to the most common presentations.
• Pyrexia was noted in 53%.
• Biochemical abnormalities encompassed anaemia (86.3%), thrombocytosis (80.3%) and hypomagnesemia (65.1%).
• The data disclosed an 83.3% concordance between intraoperative cultures and positive mid-stream urines.
• Index kidneys appeared to be prominently larger than the contralateral side (mean 1.32 cm; P=0.002).
• Staging of XGP illustarted an extension beyond the kidney in 79% of kidneys.
• In 11 cases, computed tomography (CT) was carried out.
• Herein, 0-10% function was illustrated in 90.47% of cases, via dimercaptosuccinic acid (DMSA) scan.
• Surgical procedures comprised of nephrectomy (n=63) and partial nephrectomy (n=3).
• Colonic resections (n=5) and abscess formation were discovered to be the perioperative complications in 18% subjects.