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Nephrol Dial Transplant (1999) 14: 2206-2209
© 1999 European Renal Association-European Dialysis and Transplant Association

Case Reports

Bilateral renal parenchymal malakoplakia presenting as haemolytic–uraemic syndrome

Jenn-Jye Hong1, Pei-Lun Liao1, Ja-Liang Lin1, Swei Hsueh2 and Chiu-Ching Huang1

1 Departments of Nephrology and 2 Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan

Correspondence and offprint requests to: Dr Hong Jenn-Jye, Department of Nephrology, Chang Gung Memorial Hospital, 5, Fu Hsing Street, Kuei-Shan Hsian, Taoyuan, Taiwan.

Keywords: Escherichia coli; haemolytic–uraemic syndrome; malakoplakia; urinary tract infection



   Introduction
 
Malakoplakia is a rare chronic inflammtory disease primarily occurring in immunocompromised or debilitated patients, and characterized by aggregates of macrophages containing calcospherites or Michaelis– Gutmann bodies. An immunological defect of ineffective macrophages for lysis of bacteria is believed to contribute to its pathogenesis [1].

As reported in the literature, the usual presentation of renal parenchymal malakoplakia (RPM) is that of urinary tract infection, pyelonephritis, and unilateral enlarged kidney [2]. Acute renal failure was also reported in some cases, but most associated with volume depletion, septic syndrome, urinary tract obstruction or other active systemic disease [2–4].

We report an atypical case of bilateral RPM that initially presented as urinary tract infection complicated with microangiopathic haemolytic anaemia, thrombocytopenia, and rapidly progressive renal failure which was compatible with the diagnosis of haemolytic–uraemic syndrome (HUS) in an alcoholic woman.



   Case
 
A 47-year-old aboriginal woman was admitted . . . [Full Text of this Article]



   Discussion
 


   References
 

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