An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

Patnayak, Rashmi; Reddy, Munish; Subramanian, Srinivasan; Jena, Amitabh; Ravisankar, Gangi; Dandu, Rambabu Satya

doi:10.1186/1757-1627-2-7527

Cited by 3 publications

(5 citation statements)

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“…Currently, intracellular basophilic inclusions, known as Michaelis-Gutmann bodies (MG bodies), found in von Hansemann histiocytes, are pathognomonic for malakoplakia (1,7,9) . This shows bimodal …”

Section: Discussionmentioning

confidence: 99%

“…The most accepted theory holds that chronic bacterial infections in patients with chronic weakness or immunosuppression would cause a deficit of cyclic guanosine monophosphate (cGMP) in microtubule and defective macrophage, causing them to phagocyte bacteria, but, in contrast, they would be unable to digest them due to intra-lisosomal failure. This situation would lead to intracytoplasmic deposition of fragments from bacteria, iron, and calcium, which would form the MG bodies (1,3,6,9) . In support of this theory, many studies state that these inclusions represent intake and persistence of bacteria in macrophages (4,5) .…”

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

“…incidence in age, with prevalence below 13 years of age, and in middle-aged adults, which are more affected than children. The average age of diagnosis is 50 years, with no hegemony between gender (9,10) . In cases presented here, both patients were adult, with 52 and 29 years of age.…”

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

“…Therefore, it relies on eliminating the main etiological agents currently credited, and discontinuing immunosuppressive mechanism, when possible. Surgical treatment is reserved just to eliminate possible complications (4,7,9,11) .…”

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

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Pulmonary malakoplakia associated with immunodeficiency by HTLV-1 and HIV

Madruga¹,

Nagel²,

Milito³

et al. 2014

Jornal Brasileiro De Patologia E Medicina Laboratorial

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Malakoplakia is a rare chronic inflammatory disease often confused with neoplasia. In this paper we report two cases of pulmonary Malakoplakia, both with typical clinical diagnosis of tuberculosis and lung cancer. A patient with human T-lymphotropic virus type I (HTLV-1) and diagnosis of adult T-cell leukemia/lymphoma, and another patient with human immunodeficiency virus (HIV), which was treated for tuberculosis, but, after pulmonary lobectomy, was evidenced Rodococosis equi, progressed to death.

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Section: Discussionmentioning

confidence: 99%

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

Section: Vírus T-linfotrópico Humano Tipo I (Htlv-1) E Diagnóstico Dementioning

confidence: 99%

See 2 more Smart Citations

Pulmonary malakoplakia associated with immunodeficiency by HTLV-1 and HIV

Madruga¹,

Nagel²,

Milito³

et al. 2014

Jornal Brasileiro De Patologia E Medicina Laboratorial

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“…It commonly affects the genitourinary system with bladder being the most frequently affected organ [3]. Malakoplakia can be asymptomatic or present as hematuria, bladder mass, nodule or soft yellow plaque.…”

Section: Introductionmentioning

confidence: 99%

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Wong¹,

Yeung²,

Lee³

et al. 2016

JCR

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Abstract:Introduction: Malakoplakia is a rare chronic inflammatory disease which commonly affects the urogenital tract. The exact pathogenesis is not fully understood, but some associated conditions which include immunodeficiency, malignancy or chronic bacterial infection, have been suggested. The definite diagnosis relies on identifying the Michaelis-Gutmann bodies microscopically. Case Report: A 62-year-old woman with poorly controlled diabetes mellitus presented with gross hematuria for a few months. Subsequent investigations showed a positive urine culture (Escherichia coli -E. coli), and flexible cystoscopy showed a 1 cm plaque-like lesion at the left posterior wall of the urinary bladder as well as several smaller, similar lesions noted at various different sites. Biopsy of the lesion showed a proliferation of macrophages (CD68+) with abundant, glandular cytoplasm and the presence of Michaelis-Gutmann bodies (PAS+, Von Kossa+), which was consistent with malakoplakia. Computed Tomography (CT) urogram showed no hydronephrosis, with good contrast excretion from both kidneys as well as satisfactory drainage down to the bladder. She was then treated with antibiotics, but still had on and off urinary tract infection. About a year later, she presented with urosepsis and acute renal failure, and was admitted to the urological ward. Urgent CT urogram showed bilateral hydronephrosis with both lower ureters distended with hyperdense contents (malakoplakia plaques). Emergency bilateral percutaneous nephrostomy (PCN) was performed. Her condition was stabilized with antibiotics, and her renal function improved with PCN drainage. Several treatment options were offered to the patient, but in view of her significant pre-morbid condition, she opted for bilateral long-term PCN. Conclusion: Malakoplakia was thought to be a treatable and relatively benign disease, but in some cases, it might result in renal failure due to bilateral ureteric involvement. Early diagnosis together with adequate antibiotic treatment is important in patients with malakoplakia, and they should be closely followed up to prevent future development of renal insufficiency.

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Malakoplakia of the urinary bladder: A review of the literature

Polisini

Fave

Capretti

et al. 2022

Arch Ital Urol Androl

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Objective: The aim of the study is to make a review of the literature about bladder malakoplakia. Material and Methods: We searched articles on the PUBMED web-literature database with the following keywords: “vesical malakoplakia” and “bladder malakoplakia”. In the literature we found 254 articles. At final we have excluded 219 articles, including in our study only 35 articles. Results: The overall average age found was 50.85 years. The average age of men was 43.22 years, while that of women was 53.37 years. 75% of the patient cases were women and 25% were men. Regarding comorbidities, in 5.55% of the cases were missing whereas 47.22% of the patients suffered from recurrent urinary tract infection (UTI) and 19.44% from immune system disorders. Urine culture was positive in 69.44% with E.coli being isolated in 92% of cases. Hydroureteronephrosis was present in 44.44% of the cases: left in 6.25% of cases, right in 18.75% and bilateral in 75%. The mean serum creatinine of patients with hydroureteronephrosis was 5.11 (1-21) mg/dl. The most frequent site of the lesion was the vesicoureteral junction (VUJ) (42.31%), followed by the trigone (38.46%). 30.56% of patients were treated with antibiotic and surgery (transurethral resection of bladder, partial or radical cystectomy), less frequent options were antibiotics alone and surgery alone. The recurrence rate was 15%.Conclusions: Malakoplakia is a disorder usually related to other affections, like UTI and immunodepression, and it seem to be caused by an abnormal macrophage function. In almost half of the described cases of isolated bladder malakoplakia, hydroureteronephrosis and renal failure were present.Treatment is not standardized, but both medical and surgical therapies are effective to avoid recurrence.

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An unusual case of bilateral hydroureteronephrosis caused by uretero-vesico malakoplakia in a young male: a case report and review of the literature

Abstract: Introduction: Malakoplakia is an unusual chronic inflammatory disease. Malakoplakia of the bladder and ureter is quite rare.

Cited by 3 publications

References 1 publication

Pulmonary malakoplakia associated with immunodeficiency by HTLV-1 and HIV

Pulmonary malakoplakia associated with immunodeficiency by HTLV-1 and HIV

Malakoplakia of the Urinary Tract: A Benign Disease with a Possible Malignant Outcome

Malakoplakia of the urinary bladder: A review of the literature

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