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2015 ; 2015
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Chyluria: a scourge of our region
#MMPMID26150622
Sinha RK
; Ranjan N
; Singh N
; Amit K
BMJ Case Rep
2015[Jul]; 2015
(ä): ä PMID26150622
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Chyluria is endemic in the Gangetic belt of India with an average of 90 cases
treated annually at our institute. It is almost exclusively caused by Wuchereria
bancrofti in tropical areas. Chylomicrons and triglycerides are lost in the urine
from an abnormal lymphourinary fistula due to obstructive lymphatic stasis, most
commonly at the renal pelvis. It is a distressingly recurrent condition with
multiple exacerbations and remissions over years. Severe weakness, weight loss
and haematuria occur in some patients. Diagnosis can be made by visual
examination of milky urine along with the ether test of urine for chylomicrons.
Intravenous urography is used to locate the site of the fistula, although the
detection rate is poor. Treatment starts with conservative measures such as a
high-protein low-fat diet and diethylcarbamazine therapy. In cases where
conservative measures fail, endoscopic sclerotherapy (renal pelvic instillation
of silver nitrate, povidone iodine or others) and surgical therapy are used.