Chiluria in a lymphatic filariasis endemic area

Araújo, Paulo Sérgio Ramos de; Souza, Valter Romão de; Souza, Anderson de; Fontes, Luciana de Barros Correia; Brandão, Eduardo; Rocha, Abraham

doi:10.1186/s13104-018-3357-y

Cited by 5 publications

(6 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Cystoscopy can also sometimes reveal an affected side where the milky urine is visualised as it effluxes from an ureteric orifice. 31 Retrograde pyelography can be used to identify lymphatic backflow; however, the specificity associated with this is low as similar images can be seen with contrast when injected under pressure. The role of endoscopy including retrograde pyelography is decisive in patients who have not responded to conservative or medical therapy.…”

Section: Investigationsmentioning

confidence: 99%

See 1 more Smart Citation

Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

View full text Add to dashboard Cite

Chyluria is secondary to the presence of chyle in the urine. The classical appearance on inspection is of milky white urine, which is caused by a fistulous communication between the lymphatic system and the urinary tract. Worldwide, it is most commonly associated with the parasite Wuchereria bancrofti, which is prevalent in Asia, most extensively in India but also China and Taiwan. However, in the United Kingdom, Europe and North America, where the condition is rare, non-parasitic aetiologies predominate. Chyluria is occasionally associated with other urinary tract symptoms including infection, loin pain and haematuria. It may also cause hypoproteinaemia, weight loss and cachexia. Management is based on identifying the aetiology and depends on the severity of the chyluria and presence of associated symptoms. Given its predominate symptom being urinary, cases in the West can fall under the care of the urologist. The aim of this article is to provide an overview and summary of the aetiology, assessment and management of chyluria based on the most up-to-date evidence available. This was achieved through a non-systematic review of world literature.

show abstract

Section: Investigationsmentioning

confidence: 99%

“…However, it is likely that after blood and urinary investigations the first line radiological investigations include a CT urogram and retrograde studies, largely owing to their availability. 31 For non-parasitic chyluria, on-going management would be tailored based on the suspected cause and discussion with specialist centres can be sought.…”

Section: Managementmentioning

confidence: 99%

Chyluria: what does the clinician need to know?

Stainer

Juliebø‐Jones

Juliebø

et al. 2020

Therapeutic Advances in Urology

View full text Add to dashboard Cite

show abstract

“…In the endemic areas, up to 10% may be afflicted by filariasis. 2 There are many causes of chyluria apart from filariasis (Table 1). Chyluria is a state of chronic lymphourinary reflux via fistulous communications secondary to lymphatic stasis caused by obstruction of the lymphatic flow.…”

Section: Discussionmentioning

confidence: 99%

Chyluria: Are we doing enough for filaria elimination?

Choudhury¹,

Ubale

Bari³

et al. 2022

SAJCRR

View full text Add to dashboard Cite

Filaria is known to be one of the neglected tropical disease. There are undiagnosed cases all across country due to asymptomatic nature, prolong incubation period and late manifestation of disease, ubiquitous mosquitoes and many are complacent when it comes to prevention; in part because of apathy towards the disease and pronged time it takes to manifest itself. Moreover, it is difficult to convince people to take tablet in asymptomatic stage. In this study we have reported, A 35-year-old male patient with symptoms of chronic urinary tract infection with hematuria followed by Chyluria. Mmicrofilaria was diagnosed in laboratory investigations; treated with anti-filarial drugs. However, the chyluria was not completely cleared till the last follow up indicating to lymphovenous fistula. To make India filaria free, we do not have alternative apart from shifting Mass Drug administration program from 2 drugs (albendazole + DEC) to 3 drug (Ivermectin, DEC and albendazole) MDA strategy.

show abstract

“…Epidemiological research indicates that chyluria is prevalent in hot and humid tropical nations like India, Brazil, and Vietnam, as documented in multiple studies. 4,9,10 Regarding renal involvement, currently, there is no study reporting the specific side of the kidney where the urolymphatic fistula lesion is present. Our study indicates a significant predominance of left renal involvement, accounting for over 70% of patients.…”

Section: Population Of the Studymentioning

confidence: 99%

“…This anatomical component is relevant to chyluria. 3,4 In this condition, abnormal communication occurs between lymphatic branches and the urinary tract, but the specific details regarding the quantity, location, and morphology of the lymphatic branches entering the urinary tract remain unexplored. Therefore, previous treatment methods, including silver nitrate instillation into the kidneys and soft tissue surgery ligation around the renal hilum, have been based on empirical experience rather than addressing the underlying nature of the damage.…”

Section: Introductionmentioning

confidence: 99%

Central Lymphatic Imaging in Adults with Spontaneous Chyluria

Hoa,

Cuong,

Hoan

et al. 2024

IJGM

View full text Add to dashboard Cite

Chyluria is a rare condition primarily prevalent in developing countries in tropical regions. In chyluria, there exists the communication between lymphatic vessels and the urinary tract, but the specific mechanism of this communication remains undocumented. The objective of this study was to assess the morphology of the main lymphatic vessels including the urolymphatic fistula, the thoracic duct using Magnetic Resonance Lymphangiography (MRL) and Intranodal Lymphangiography (IL). Materials and Methods: A retrospective study spanning five years, from January 2020 to January 2024, included 43 patients diagnosed with chyluria through cystoscopy and quantitative urine testing for triglycerides. These patients underwent MRL and then IL for uro-lymphatic fistula embolization. Results:The study involved 43 patients with an average age of 66.1 ± 19.5 years, with a male-to-female ratio of 1:2. Uro-lymphatic fistula occurred predominantly in the left kidney (72.1%), followed by the right kidney (20.9%), and both sides (7%). MRL imaging showed the thoracic duct in 100% of cases but visualized only 84.5% of the uro-lymphatic fistulas. In contrast, IL imaging showed the thoracic duct in 51.5% of patients but visualized uro-lymphatic fistulas in 100% of cases. In the procedure of IL, the average visualization time of the thoracic duct was 45 minutes, with a range of 35 to 69 minutes. Conclusion: MRL and IL complement each other in diagnosing the main lymphatic vessels in chyluria patients. The observed circulatory stasis in the thoracic duct supports the hypothesis that it contributes to increased pressure in the thoracic duct and the formation uro-lymphatic fistula as collateral circulations.

show abstract

Chiluria in a lymphatic filariasis endemic area

Cited by 5 publications

References 28 publications

Chyluria: what does the clinician need to know?

Chyluria: what does the clinician need to know?

Chyluria: Are we doing enough for filaria elimination?

Central Lymphatic Imaging in Adults with Spontaneous Chyluria

Contact Info

Product

Resources

About