Lobar nephronia
Updates to Article Attributes
Lobar nephronia, also known as acute focal nephritis, refers to an intermediate stage between acute pyelonephritis and renal abscess, and is a focal region of interstitial nephritis.
It appears as a wedge of poorly perfused renal parenchyma, without a cortical rim sign.
The condition is discussed further as part of the article on acute pyelonephritis.
Epidemiology
Acute lobar nephronia is commonly found in children. However, immunosuppressed adults, those with abnormalities in the genitourinary tract, or have other underlying conditions such as diabetes mellitus and liver cirrhosis may also be affected by this condition 2.
Clinical presentation
Clinical features for nephronia are similar to acute pyelonephritis and renal abscess 2:
fever
flank pain
leucocytosis
pyuria
elevated C-reactive protein
Radiographic features
Ultrasound
bulky kidney
loss of cortico-medullary differentiation 2
CT
Contrasted CT scan is the gold standard for diagnosing nephronia. It shows a wedge shaped non-enhancing lesion with ill-defined borders 2
History and etymology
Nephronia was first described by Rosenfield et al in 1978 2.
Differential diagnosis
renal infarction: in these patients the cortical rim sign is present, and clinical presentation is different, without inflammatory/infectious symptoms
-<p><strong>Lobar nephronia</strong>, also known as <strong>acute focal nephritis</strong>, refers to an intermediate stage between <a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a> and <a href="/articles/renal-abscess">renal abscess</a>, and is a focal region of interstitial nephritis. </p><p>It appears as a wedge of poorly perfused renal parenchyma, without a <a href="/articles/cortical-rim-sign-kidneys-1">cortical rim sign</a>.</p><p>The condition is discussed further as part of the article on <a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a>.</p><h4>Epidemiology</h4><p>Acute lobar nephronia is commonly found in children. However, immunosuppressed adults, those with abnormalities in the genitourinary tract, or have other underlying conditions such as diabetes mellitus and liver cirrhosis may also be affected by this condition <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Clinical features for nephronia are similar to acute pyelonephritis and renal abscess <sup>2</sup>:</p><ul>- +<p><strong>Lobar nephronia</strong>, also known as <strong>acute focal nephritis</strong>, refers to an intermediate stage between <a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a> and <a href="/articles/renal-abscess">renal abscess</a>, and is a focal region of interstitial nephritis. </p><p>It appears as a wedge of poorly perfused renal parenchyma, without a <a href="/articles/cortical-rim-sign-kidneys-1">cortical rim sign</a>.</p><p>The condition is discussed further as part of the article on <a href="/articles/acute-pyelonephritis-1">acute pyelonephritis</a>.</p><h4>Epidemiology</h4><p>Acute lobar nephronia is commonly found in children. However, immunosuppressed adults, those with abnormalities in the genitourinary tract, or have other underlying conditions such as diabetes mellitus and liver cirrhosis may also be affected by this condition <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Clinical features for nephronia are similar to acute pyelonephritis and renal abscess <sup>2</sup>:</p><ul>
Image 5 CT (C+ portal venous phase) ( create )
