CASE REPORT End stage renal disease due to bilateral renal malakoplakia

Malakoplakia typically affects the bladders of immunocom-promised adults who have defective intracellular killing of Escherichia coli. Renal malakoplakia is rare in children and generally has a good outcome. In the case presented, however, it caused end stage renal failure in a 5 year old girl. The management dilemmas surrounding renal trans-plantation are highlighted. M alakoplakia, meaning soft plaque, is an uncommon chronic granulomatous inflammatory disorder pri-marily affecting the urinary collecting system in immunocompromised or debilitated adults. It can also affect renal parenchyma and other sites in adults, and rarely in children.1 The underlying abnormality appears to be defective macrophage lysosomal digestion of phagocytosed bacteria