Clinical progression of megacalycosis in a girl with a solitary kidney: The lesson learned

Introduction: Megacalycosis is a rare disorder related to congenitalunderdevelopment of the renal papilla or structural defect of the renal calyces.Megacalycosis has a wide spectrum of clinical presentations ranging from simplevariants without any significance on renal function to severe complications. Anyprevention strategy is recommended yet since megacalycosis is mostly asymptomaticand usually discovered either accidentally or as result of its complications.Case presentation: We observed megacalycosis progression in a young female with asingle kidney toward progressive calyx dilatation for years, which ended in acutepyelonephritis. Conservative management, urinary drainage, and large-spectrumantibiotics were unsuccessful and nephrectomy was required.Conclusion: This rare case and literature review add evidence to identify prognosticfactors to select patients with a high risk of complications (single kidney, bilateraldisease, female gender, associated genetic syndromes, vesicoureteral reflux, andcontralateral renal disorder). One o more factors should activate close monitoring andprophylactic therapy if needed.