Xanthogranulomatous Pyelonephritis Clinical Presentation

Updated: Mar 15, 2021
  • Author: Samuel G Deem, DO; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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Presentation

History and Physical Examination

Patients with xanthogranulomatous pyelonephritis (XGP) often appear chronically ill. Symptoms include anorexia, fever, chills, weight loss, and flank pain. The pain of XGP is not colicky in nature; it is usually dull and persistent. [11]

XGP is notorious for fistulization. Pyelocutaneous and ureterocutaneous fistulae have been well described. Other organs are occasionally involved in this process, including surrounding viscera (with resulting pyeloenteric fistulae). [12]

Obstruction associated with XGP in the pediatric population is more likely to be due to congenital factors than to obstructive calculi.

As an illustration of the varied presentation of XGP, a case report by Hitti et al describes XGP located in a renal allograft. [13] Another report describes a case of XGP associated with psoas abscess in a young pregnant woman in her third trimester. [14]