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At the time the article was created Craig Hacking had no recorded disclosures.View Craig Hacking's current disclosures
At the time the article was last revised Rohit Sharma had no recorded disclosures.View Rohit Sharma's current disclosures
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