Xanthogranulomatous pyelonephritis is a rare type of pyelonephritis associated with chronic and/or recurrent bacterial infections. Its diagnosis can be challenging, especially if it is not considered in the differential diagnosis of a renal mass.
It is usually seen in an older adult female but can present at any age.
Clinical features of xanthomatous pyelonephritis:
(1) palpable renal or flank mass
(2) hematuria
(3) intermittent fevers
(4) history of recurrent urinary tract infection and/or nephrolithiasis
(5) abdominal or lumbar pain
(6) anorexia with weight loss
Laboratory features:
(1) anemia
(2) elevated erythrocyte sedimentation rate (ESR) or C-reactive protein (CRP)
Differential diagnosis:
(1) renal tumor
(2) perinephric abscess
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