Citation, DOI & article data
Autonephrectomy refers to the end stage of renal tuberculosis where chronic tuberculous infection causes caseous necrosis and progressive renal cavitation, rendering the kidney non-functioning 1.
It is a rare occurrence in non-endemic populations today but can be misdiagnosed if not suspected 2.
There are two types described in literature 3,4:
- caseous-cavernous: conversion of the kidney into an enlarged, debris-filled caseated sac resulting in substantial parenchymal loss, calcification may be present
- fibrous-sclerotic: extensive parenchymal fibrosis and scarring results in shrinkage of the kidney, often with dystrophic calcification in a lobar distribution that is characteristic of end stage disease 5,6
Treatment and prognosis
A secondary nephrectomy is not usually required except in specific cases (e.g. intractable hypertension, tuberculous reactivation) 1.
Autonephrectomy is distinct from putty kidney, which can also result from chronic tuberculous infection.
- 1. Amie Victoria Clifford, Aidan Paul Noon, Daniel Raw, James Hall. Renal calcified mass misdiagnosed as a renal calculus in an adult with tuberculosis "autonephrectomy": a case report. (2009) Cases Journal. 2 (1): 1. doi:10.4076/1757-1626-2-7613 - Pubmed
- 2. Sinha RJ, Jhanwar A, Singh V, Sharma K, Prakash G, Mehrotra CN. Autonephrectomy due to urogenital tuberculosis. (2017) Asian journal of urology. 4 (2): 135-136. doi:10.1016/j.ajur.2016.08.007 - Pubmed
- 3. Suleman Merchant, Alpa Bharati, Neesha Merchant. Tuberculosis of the genitourinary system-Urinary tract tuberculosis: Renal tuberculosis-Part I. (2013) Indian Journal of Radiology and Imaging. 23 (1): 46. doi:10.4103/0971-3026.113615 - Pubmed
- 4. TWO EXTREME FORMS OF AUTONEPHRECTOMY IN RENAL TUBERCULOSIS. (1951) British Journal of Urology. 23 (1): 52. doi:10.1111/j.1464-410X.1951.tb02560.x
- 5. Caterina Gaudiano, Marina Tadolini, Fiorenza Busato, Elisa Vanino, Simone Pucci, Beniamino Corcioni, Rita Golfieri. Multidetector CT urography in urogenital tuberculosis: use of reformatted images for the assessment of the radiological findings. A pictorial essay. (2017) Abdominal Radiology. 42 (9): 2314. doi:10.1007/s00261-017-1129-0 - Pubmed
- 6. Gülgün Engin, Bülent Acunaş, Gülden Acunaş, Mehtap Tunaci. Imaging of Extrapulmonary Tuberculosis. (2000) RadioGraphics. 20 (2): 471-88; quiz 529-30, 532. doi:10.1148/radiographics.20.2.g00mc07471 - Pubmed