An occult filarial infection presenting as chyluria with proteinuria: a case report and review of literature

Saha, Manideepa; Ray, Sayantan; Goswami, Manas; Kundu, Supratip; Saha, Puranjay; Saha, Avishek; Maitra, Somnath; Talukdar, Arunansu

doi:10.1136/bcr.01.2012.5635

Cited by 11 publications

(3 citation statements)

References 8 publications

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“…Sometimes chyluria can be mistaken for proteinuria of nephrotic syndrome . Hypocholesterolemia is a characteristic feature of chyluria, and helps to differentiate it from proteinuria of nephrotic syndrome, where hypercholesterolemia is a feature .…”

Section: Clinical Featuresmentioning

confidence: 99%

“…Sometimes chyluria can be mistaken for proteinuria of nephrotic syndrome. 10,24,25 Hypocholesterolemia is a characteristic feature of chyluria, and helps to differentiate it from proteinuria of nephrotic syndrome, where hypercholesterolemia is a feature. 26 This differentiation is critical to avoid unnecessary renal biopsy in patients with heavy proteinuria as a result of chyluria rather than nephrotic syndrome.…”

Section: Clinical Featuresmentioning

confidence: 99%

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New developments in chyluria after global programs to eliminate lymphatic filariasis

2017

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Chyluria, commonly seen in south Asian countries, is mainly a manifestation of lymphatic filariasis as a result of infestation with Wuchereria bancrofti, although many other causes can contribute. Many patients can be effectively treated with dietary modifications and drug therapy. The most widely used drug is diethyl carbamazine. The recurrences are common after such treatment. Such patients would benefit from sclerotherapy to obliterate the lympatico-renal fistulae located mainly in the renal pelvicalyceal system. The commonly used sclerosing agent is a combination of 5% povidone-iodine and 50% dextrose instilled through a ureteric catheter. A small percentage of patients who recur after sclerotherapy and those with systemic complications, such as hypoproteinemia and edema, might require surgery in the form of renal hilar lymphatic disconnection. Although it is a major operation, the success rates are >90%. Laparoscopic and robotic techniques have minimized the morbidity related to such surgery. With the advent of the global program for eradication of filariasis initiated by the World Health Organization, the incidence of the disease is decreasing. Mass chemotherapy with diethyl carbamazine is the mainstay of this global program. Many years after eliminating filariasis, chyluria continue to occur in such populations, though in dwindling numbers. Future research should aim at finding more efficacious sclerosing agents with minimal recurrences.

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Section: Clinical Featuresmentioning

confidence: 99%

Section: Clinical Featuresmentioning

confidence: 99%

New developments in chyluria after global programs to eliminate lymphatic filariasis

2017

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“…Saha et al diagnosed chyluria by lymphoscintigraphy and found their patient to be positive for filariasis. They treated the patient with diethylcarbamazine initially; however, surgical closure was needed, as the patient did not respond to medical therapy [ 13 ]. Sivashankar et al reported a case of chyluria that was managed by endoscopic sclerotherapy [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Chyluria Associated With Nephrotic-Range Proteinuria

Kaur¹,

Kandari²,

Saini³

et al. 2022

Cureus

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Chyluria is the presence of chyle in the urine and is associated with some degree of proteinuria. We report two patients with chyluria who presented with milky urine, weight loss, and edema and were found to have nephrotic-range proteinuria. Although filarial antigen was detected in only one of the patients, flexible cystoscopy could demonstrate chyle efflux from the left ureter in first patient and from both the ureters in the second patient. Both patients received endoscopic sclerotherapy with 0.2% povidone-iodine, which resulted in the clearance of milky urine in three to five days and complete resolution of nephrotic-range proteinuria on follow-up. They remained symptom-free until the six-month follow-up. We deferred renal biopsy in both patients, as proteinuria was confirmed to be non-glomerular in origin.

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Infections That Affect the Kidney (Nonviral)

Iyengar

Koch

2022

Pediatric Nephrology

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An occult filarial infection presenting as chyluria with proteinuria: a case report and review of literature

Cited by 11 publications

References 8 publications

New developments in chyluria after global programs to eliminate lymphatic filariasis

New developments in chyluria after global programs to eliminate lymphatic filariasis

Chyluria Associated With Nephrotic-Range Proteinuria

Infections That Affect the Kidney (Nonviral)

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