Change of Chylous Ascites During Low‐Density Lipoprotein Apheresis in a Patient With Idiopathic Nephrotic Syndrome

Iwazu, Yoshitaka; Komori, Seiichi; Nagata, Daisuke

doi:10.1111/1744-9987.12225

Cited by 1 publication

(1 citation statement)

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“…3 We identified 11 cases of proteinuric glomerulonephritis associated with chylous ascites in the medical literature, of which only 4 cases were recognized as focal segmental glomerulosclerosis ( Table 2), and all were associated with severe hypoalbuminemia, with a serum albumin < 2.0 g/dL ( Table 2). [2][3][4][5][6][7][8][9][10][11][12] Lymphatic obstruction and abnormal lymphatic drainage has been described in both nephrotic and nonnephrotic patients with chylous ascites. 1,2 Our nephrotic patient had no abnormal lymph leakage or obstruction, as demonstrated by normal lymphoscintigraphy (Figure 3A).…”

Section: Diagnosismentioning

confidence: 99%

Renal Thrombotic Microangiopathy, Podocytopathy, and Chylous Ascites: A Hard-Nosed Diagnosis

McMahon

Moran

Sperati

et al. 2016

The American Journal of Medicine

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A 67-year-old Sub-Saharan African man presented to an outside institution with progressive, painless abdominal distention, anorexia, leg swelling, and dyspnea on exertion. He had not seen a physician in many years. He denied alcohol use, intravenous drug use, or any recent surgery. He was referred to our institution for a second opinion. On physical examination, he was alert and orientated. His temperature, pulse, blood pressure, and room air oxygen saturation were 36.1 C, 82 beats per minute, 115/73 mm Hg, and 99%, respectively. He had no purpura and no stigmata of chronic liver disease. He had 3þ pitting edema to the hips and a distended nontense abdomen with shifting dullness. ASSESSMENT Laboratory studies revealed hemoglobin of 13.9 g/dL (ref: 13.9-16.3 g/L), platelet count of 101 K/cu mm (ref: 150-350 K/cu mm), and creatinine of 6.8 mg/dL (ref: 0.6-1.3 mg/dL) (no prior baseline known) corresponding to an estimated glomerular filtration rate (eGFR) of 10 mL/min/1.73m 2 and a serum albumin of 1.4 g/L (ref: 3.5-5.3g/dL). Urinalysis revealed 3þ protein. Urine microscopy demonstrated fatty casts, fine granular casts, and oval fat bodies, but no red or white cell casts. A 24-hour urine collection noted 16.1 g of proteinuria (ref: 0-100 mg/24 h). He had normal liver Funding: None.

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