Chyluria of Filarial Origin

Ray, P. N.; Rao, S. Sundar

doi:10.1111/j.1464-410x.1939.tb10357.x

Cited by 26 publications

(6 citation statements)

References 3 publications

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“…Two studies have investigated the prevalence of chyluria. In an endemic area of China, the Kinmen islands, chyluria was present in only 0.7% of the population [13] and in a cohort of urologic patients with diagnosed fi larial infection the prevalence was as low as 2% [14]. Th e non-parasitic causes of chyluria are rare and include granulomatous diseases, such as tuberculosis, leprosy, and fungal infection.…”

Section: Discussionmentioning

confidence: 99%

A rare case of milky urine

Neuwirt

Eller

Tiefenthaler

et al. 2010

Wien Klin Wochenschr

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Chyluria is an uncommon condition characterized by lymphatic fluid excretion into the urinary tract. Most common causes of chyluria are infections by parasites e.g. filariasis, echinococcosis, or cysticercosis. Nonparasitic chyluria is a very rare condition and possible etiologies include granulomatous disease (e.g. tuberculosis, leprosy, and fungal infection), malignomes, inherited and acquired malformation (posttraumatic), pregnancy, or aortic aneurysm. We present a case of a 73-year-old man, born and raised in Taiwan, but living in Austria for the past 5 years. He was admitted in our department by a general practitioner due to milky urine, whose turbidity increased after meal. All tests for infectious diseases or other above-mentioned causes remained negative. Additionally, although flexible cystoscopy yielded in a clear diagnosis of a milky urine jet out of the right urether, CT urography and bipedal lymphangiography failed to locate the lymphorenal fistula. Due to a stable renal function and absence of lipid metabolism disorders, a conservative management of the patient was chosen.

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Section: Discussionmentioning

confidence: 99%

A rare case of milky urine

Neuwirt

Eller

Tiefenthaler

et al. 2010

Wien Klin Wochenschr

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“…Chyluria is a late and uncommon manifestation of chronic lymphatic filariasis [2,3]. In one epidemiologic study, chyluria was present in 0.7% of the population in an endemic area, and in another clinical study, chyluria was diagnosed in 2% of urologic patients with filarial infection [7,8].…”

Section: Discussionmentioning

confidence: 99%

“…Further evaluation of chyluria includes localization of the side, the site, and the level of lymphatic urinary fistula, and the assessment of the underlying etiology. This is best achieved by performing cystoscopy after a fatty meal, allowing the identification of the ureteral orifice that is passing milky urine or a site of chylous efflux into the bladder or urethra [2,8]. This is followed by lymphangiography for the detection of the level and site of lymphatic urinary fistula formation.…”

Section: Volume 2 Issue -3mentioning

confidence: 99%

Chyluria Presenting as a Non Glomerular Origin of Nephrotic-Range Proteinuria

Abdallah

Helal

et al. 2018

ETUN

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Background: Chyluria (excretion of chyle from the urinary tract) is a rare condition that can be mistaken for nephrotic syndrome because of its presentation with heavy proteinuria, hypoalbuminemia, and edema. We report a case of chyluria presented with milky urine and nephrotic-range proteinuia.Case presentation: A 36-year-old Bangladesh woman gave a history of episodic cloudy urine for the last 2 years (2014 after 2nd pregnancy). history of 3 month abortion 2015. During her last pregnancy (2014), she was noted to have proteinuria (5g/24 h). Physical examination was normal. Renal function test was normal, absolute esinophilia. Urine analysis revealed milky urine, protein 5g/l, no cast, no dysmorphic RBCS, urine cholesterol 0.52mmol/l (n 0-0.26), urine triglycerides 7.04mmol/l (n 0-0.1). A 24-h urine collection was 6.8g of protein. Anti nuclear antibody, anti DS DNA and ANCA were -ve. Complement C3 and C4 were normal. Hepatitis C antibody and hepatitis B surface antigen were -ve. An abdominal ultrasound showed the kidneys were normal in size, position and echotexture. Differential diagnosis of the nephrotic-range proteinuria was membranous nephropathy or minimal change disease or chyluria. Kidney biopsy findings of intact foot processes and absence of glomerular histologic abnormalities are helpful to exclude intrinsic renal disease and should prompt an appropriate work-up for chyluria. Conclusion:Chyluria should be considered in the differential diagnosis of the patient who presents with cloudy or milky urine.

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“…2,3 In one epidemiologic study, chyluria was present in 0.7% of the population in an endemic area, 7 and in another clinical study, chyluria was diagnosed in 2% of urologic patients with filarial infection. 8 Diagnosis of lymphatic filariasis is usually made by the detection of microfilariae on thick Giemsa-stained blood smears, which requires late night examination (around midnight) because of the nocturnal periodicity of the circulating parasites. During the day, microfilariae reside in the capillary beds of deep visceral organs, such as the lungs, and enter the blood stream during the night, coinciding with the time of peak biting frequency of the mosquito vector.…”

Section: Discussionmentioning

confidence: 99%

Chyluria presenting as milky urine and nephrotic-range proteinuria

Cheng

Mohan

Nasr

et al. 2006

Kidney International

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CASE PRESENTATIONA 41-year-old woman was admitted to Harlem Hospital Center for the evaluation of nephrotic-range proteinuria, microhematuria, hypoalbuminemia, and edema. The patient was born in the Dominican Republic and came to the United States 10 years ago. She gave a history of episodic cloudy urine for the past 28 years. Five years before admission during her last pregnancy, she was noted to have proteinuria (2 g/24 h). Two years before admission, she was treated for filariasis at another hospital, and after 1 year, she was admitted to the same hospital for edema and was found to have chronic active hepatitis C infection with incipient cirrhosis by liver biopsy. For the past 3 months, the patient noted progressive swelling of both lower extremities associated with episodic passage of cloudy urine and flank pain. There was no history of diabetes mellitus, hypertension, renal stones, or gross hematuria. She was on no medications and denied alcohol, illicit drug, and tobacco use.Physical examination revealed a thin and malnourished woman weighing 55.5 kg with a temperature of 371C, pulse 92/min, and blood pressure 104/60 mmHg. There was no skin rash. The heart and lung examinations were normal. The abdomen was soft with the liver palpable 3 cm below the right costal margin. The spleen was not palpable and there was no shifting dullness. There was 3 þ pitting bilateral pedal edema.Laboratory data on the current admission included hematocrit 46% (reference interval, 42-52%), white blood count 6.6 Â 10 9 /l (reference interval, 4.0-10.5 Â 10 9 /l) with normal differential, platelet count 381 Â 10 9 /l (reference interval, 150-500 Â 10 9 /l), blood urea nitrogen 7 mg/dl (2.5 mmol/l) (reference interval, 7-18 mg/dl, 2.5-6.4 mmol/l), serum creatinine 0.7 mg/dl (63 lmol/l), total protein 4.1 g/ dl (41 g/l) (reference interval 6.0-7.8 g/dl, 60-78 g/l), albumin 1.9 g/dl (19 g/l) (reference interval 3.5-5.0 g/ dl,35-50 g/l), bilirubin 0.

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Chyluria of Filarial Origin

Cited by 26 publications

References 3 publications

A rare case of milky urine

A rare case of milky urine

Chyluria Presenting as a Non Glomerular Origin of Nephrotic-Range Proteinuria

Chyluria presenting as milky urine and nephrotic-range proteinuria

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