Pyelonephritis other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Other diagnostic studies for pyelonephritis include dimercaptosuccinic acid scintigraphy and histopathological exam.

Other Diagnostic Studies

Renal biopsy

  • A biopsy can be done to confirm the diagnosis of a complex renal pathology or to check the extent and type of damage to the kidney.
  • It is used specifically in case of xanthogranulomatous pyelonephritis that is confused with renal tumors usually Wilm's tumor.
  • The histopathological exam of the biopsy specimen confirm xanthogranulomatous type of pyelonephritis.

Dimercaptosuccinic acid (DMSA) scintigraphy

DMSA scintigraphy is based on the identification of radiation in minute quantities after injecting a radioactive material. Since the radioactive material is used in a minute quantity, there is less risk of cell damage. It can be performed in an outpatient or inpatient setting by qualified personnel. This investigation can be carried out in the absence of anesthesia. Radioactive substance injected an arm vein reaches the kidneys. Attached cameras create images of the path taken by the radioactive substance. The effected parts of the kidney become prominent. DMSA scintigraphy shows the extent of kidney involvement. Cortical Scintigraphy is preferred for the diagnosis of acute pyelonephritis in children.[1][2][3]

Histopathological exam

Xanthoranulomatous pyelonephritis is usually confused with a malignancy and surgery is performed. The histopathological examination of the resected specimen confirms xanthogranulomatous pyelonephritis which is not a very common phenomenon. Microscopic examination after performing biopsy shows the inflammatory mass composed of lipid-laden macrophages and chronic inflammatory cells.[4]

References

  1. Salihoglu YS, Elri T, Gulle K, Can M, Aras M, Ozacmak HS; et al. (2016). "Evaluation of the protective effect of agmatine against cisplatin nephrotoxicity with 99mTc-DMSA renal scintigraphy and cystatin-C". Ren Fail. 38 (9): 1496–1502. doi:10.1080/0886022X.2016.1227919. PMID 27604130.
  2. Benador D, Benador N, Slosman DO, Nusslé D, Mermillod B, Girardin E (1994). "Cortical scintigraphy in the evaluation of renal parenchymal changes in children with pyelonephritis". J Pediatr. 124 (1): 17–20. PMID 8283371.
  3. Kawashima A, LeRoy AJ (2003). "Radiologic evaluation of patients with renal infections". Infect Dis Clin North Am. 17 (2): 433–56. PMID 12848478.
  4. Yeow Y, Chong YL (2016). "Xanthogranulomatous pyelonephritis presenting as Proteus preperitoneal abscess". J Surg Case Rep. 2016 (12). doi:10.1093/jscr/rjw211. PMC 5159021. PMID 27915241.

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