Investigating the relationship between clinical, laboratory and radiological findings in hospitalized patients diagnosed with xanthogranulomatous pyelonephritis who referred to Ali Ebn Abitaleb Hospital fron 2018-2022

Background and Objective: Considering the high rate of unfavorable diagnosis of XGP and doctors’ inadequate familiarity, this research was conducted with the aim of determining clinical, laboratory, and radiological findings in patients diagnosed with xanthogranulomatous pyelonephritis referred to Ali Bin Abitalib Hospital from 2018 to 2022. Materials and Methods: In this retrospective study, 23 patients diagnosed with xanthogranulomatous pyelonephritis were assessed in Ali Bin Abitalib Zahedan Hospital between 2018 and 2022. The diagnosis of XGP was evaluated retrospectively based on the findings of renal ultrasound and CT scan, according to the distribution and extent of XGP, kidney size, the presence of stones, the pattern of renal lesions, and lack of contrast enhancement in the affected kidney. In addition, the diagnosis of pathological cases of XGP was determined based on the presence of focal or diffuse processes with the presence of lipid-laden macrophages in a chronic inflammatory context in the kidney. Finally, the information obtained was analyzed using SPSS statistical software (version 26). Results: The mean age of patients diagnosed with xanthogranulomatous pyelonephritis was 48.17±11.45 years, respectively. The frequency distribution of gender in the study subjects was 18 (78.27%) women and 5 (21.73%) men. The rate of clinical symptoms in patients diagnosed with xanthogranulomatous pyelonephritis was as follows: flank pain or tenderness (91.3%; n=17), history of fever (over 38 degrees) (73.91%; n=17), hematuria Gross 6 (26.08%), dysuria (21.73%; n=5), weight loss (17.39%; n=4), and palpable mass (8.69%; n=2). The findings from the tests of patients diagnosed with xanthogranulomatous pyelonephritis demonstrated that 20 (86.95%) patients had pyuria, 17 (73.91%) cases had leukocytosis, 13 (56.52%) patients had anemia, 11 (47.82%) patients had hematuria, 9 (39.13%) subject had high CRP, and 7 (30.43%) cases had high ESR. The results of CT-Scan interpretation in patients diagnosed with xanthogranulomatous pyelonephritis illustrated that 13 (56.52%) patients had Renal Calculi, and 4 (17.39%) cases had Staghorn Stone. Moreover, regarding fluid/air accumulation, 14 (60.86%) patients had abdominal abscesses (retroperitoneal, intraparenchymal or psoas) and 1 patient had a fistula of Nephrocutaneous Fistula type. Conclusion: Despite the low prevalence of xanthogranulomatous pyelonephritis, it is recommended that when faced with chronic pyelonephritis (characterized by clinical symptoms such as fever and chills, tenderness, flank pain, and heartburn), doctors and specialists in kidney and urinary tract surgery among consider XGP disease differential diagnoses in order to manage these patients well in the presence of kidney stones and positive urine culture and perform surgical procedures at the right time