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Santos-Seoane, V. Arenas-García, R.J. Delgado-Sevillano" "autores" => array:3 [ 0 => array:4 [ "nombre" => "S.M." "apellidos" => "Santos-Seoane" "email" => array:1 [ 0 => "smsspulp@yahoo.es" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "V." "apellidos" => "Arenas-García" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] 2 => array:3 [ "nombre" => "R.J." "apellidos" => "Delgado-Sevillano" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital Universitario San Agustín, Avilés, Asturias, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Radiología, Hospital Universitario San Agustín, Avilés, Asturias, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Riñón mastic" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1400 "Tamanyo" => 153758 ] ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 90-year-old man with no known history of tuberculosis was admitted for abdominal pain. Computed tomography confirmed the presence of acute appendicitis. Multiple calcifications were incidentally detected in the left kidney, along with notable cortical atrophy and a renal parenchyma partially replaced by pseudonodular lesions with low attenuation content with no contrast uptake, findings compatible with mastic kidney (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a> A–C, in cross-sectional, frontal and sagittal slices, respectively). The patient reported episodes of self-limiting hematuria, with negative urine cultures. The direct smears for bacilli and the urinary mycobacteria cultures were positive, confirming renal tuberculosis.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Urogenital tuberculosis is the third most common form of extrapulmonary tuberculosis after lymph node tuberculosis and pleural effusion. Unilateral involvement of the pelvis, calyxes, ureters and bladder is more common than parenchymal involvement. The condition can present as persistent pyuria with repeatedly negative cultures or as painless micro/macroscopic hematuria, with systemic symptoms being rare.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The demonstration of bacilli in urine establishes the diagnosis. Concomitant radiological disorders in the upper and lower urinary tract are highly suggestive. Stricture of the collecting system, asymmetric caliectasis, calcification, hydronephrosis and even autonephrectomy are possible. Based on suggestive radiological findings and negative urine tests, fine-needle aspiration cytology and renal or bladder biopsy should be performed for cultures and histopathology studies.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The treatment is similar to that of pulmonary tuberculosis. Surgery should be deferred until after at least 4 weeks of treatment. Nephrectomy, dilation/reconstruction of the ureteral stricture or urinary diversion may be performed. Nephrectomy would be indicated for nonfunctioning kidneys, extensive disease with hypertension and obstruction of the ureteropelvic junction or for the coexistence of renal carcinoma.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-03-07" "fechaAceptado" => "2018-04-17" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Santos-Seoane SM, Arenas-García V, Delgado-Sevillano RJ. Riñón mastic. Rev Clin Esp. 2019;219:53–54.</p>" ] ] "multimedia" => array:1 [ 0 => array:6 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1200 "Ancho" => 1400 "Tamanyo" => 153758 ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/22548874/0000021900000001/v1_201901300620/S2254887418300948/v1_201901300620/en/main.assets" "Apartado" => array:4 [ "identificador" => "71811" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Medicine in images" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/22548874/0000021900000001/v1_201901300620/S2254887418300948/v1_201901300620/en/main.pdf?idApp=WRCEE&text.app=https://revclinesp.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2254887418300948?idApp=WRCEE" ]
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