Medical Radiology and Radiation Safety. 2026. Vol. 71. № 2

DOI:10.33266/1024-6177-2026-71-2-122-128

A.A. Sazhina, A.N. Bashkov, Yu.D. Udalov, E.I. Matkevich, S.V. Lischuk

Reccurent Papillary Necrosis of the Right Kidney in the Setting of Drud-Induced Nephritis:
a Case Report on Radiologic Diagnosis

A.I. Burnazyan Federal Medical Biophysical Center, Moscow, Russia

Contact person: A.A. Sazhina, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

Purpose: To present a histologically verified clinical case of renal papillary necrosis that developed as a complication of drug-induced nephritis and was accompanied by secondary obstructive suppurative destructive pyelonephritis, with an emphasis on the diagnostic capabilities of radiological imaging.

Material and methods: А clinical case of a female patient with acute suppurative destructive pyelonephritis complicated by papillary necrosis, who was hospitalized in our clinic in January–February 2018.

Results: This case highlights the diagnostic value of CT in detecting papillary necrosis and determining the extent of renal involvement, which is crucial for treatment planning. Notably, papillary necrosis developed in the absence of classical risk factors such as diabetes mellitus or long-term analgesic abuse, underlining the significance of infectious-obstructive mechanisms.

Conclusion: This case illustrates a rare and complex course of drug-induced nephritis complicated by the development of renal papillary necrosis and secondary obstructive suppurative destructive pyelonephritis. Contrast-enhanced multislice computed tomography proved to be the most informative imaging modality, revealing calicopyeloectasia, filling defects, and characteristic signs of papillary necrosis, whereas MRI was less informative due to the absence of collecting system dilatation. Renal papillary necrosis should be considered as a potential cause of gross hematuria, particularly in patients with a history of prolonged analgesic use, as early recognition of this condition may prevent severe infectious and destructive complications. This case emphasizes the importance of an integrated diagnostic approach combining clinical, laboratory, radiological, and histopathological findings to ensure accurate diagnosis and optimal management strategy.

Keywords: renal papillary necrosis, acute suppurative destructive pyelonephritis, computed tomography (CT), multislice CT (MSCT), case report, nephrectomy, clinical case

For citation: Sazhina AA, Bashkov AN, Udalov YuD, Matkevich EI, Lischuk SV. Reccurent Papillary Necrosis of the Right Kidney in the Setting of Drud-Induced Nephritis: a Case Report on Radiologic Diagnosis. Medical Radiology and Radiation Safety. 2026;71(2):122–128. DOI:10.33266/1024-6177-2026-71-2-122-128

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 20.02.2026. Accepted for publication: 25.03.2026.