Damodara Rao Mendu1, Hillel Sternlicht2, Lakshmi V Ramanathan1, Melissa S Pessin1, Martin Fleisher1, Guido Dalbagni3, Edgar A Jaimes4, Anna Kaltsas5, Ilya G Glezerman6. 1. Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 2. Division of Nephrology, Department of Medicine, Lenox Hill Hospital, New York, NY, United States. 3. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 4. Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 5. Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Infectious Disease Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States. 6. Division of Nephrology & Hypertension, Department of Medicine, Weill Cornell Medical College, New York, NY, United States; Renal Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States. Electronic address: glezermi@mskcc.org.
Abstract
OBJECTIVES: Chyluria is a medical condition with presence of chyle in urine. The disease is most prevalent in South East Asian countries mostly caused by parasitic (Wuchereria bancrofti) infections. Our objective was to investigate the spontaneous remission of non-parasitic chyluria. DESIGN AND METHODS: The spontaneous remission of non-parasitic chyluria cases were worked up with diagnostic investigations, clinical assessment and studied in detail with respect to their natural evolution. RESULTS: We present two patients who were evaluated in the nephrology clinic with symptoms of milky urine and painless hematuria. Midnight blood smear was negative for filarial parasites. Urine culture was without mycobacteria. Urine cytology and IgG western blot for cysticercus were negative. Imaging for a lymphatic leak by lymphoscintigraphy was unrevealing. Chyluria resolved spontaneously in both patients. CONCLUSIONS: In our cases, radiologic visualization via lymphoscintigraphy was unrevealing. The patients were managed conservatively and fortunately underwent spontaneous remission marked by the disappearance of chyluria within several months of her initial diagnosis. In our opinion this spontaneous remission could be due to unrevealed lymphatico-renal fistula collapse or sclerosis of lymphatics caused by contrast media.
OBJECTIVES: Chyluria is a medical condition with presence of chyle in urine. The disease is most prevalent in South East Asian countries mostly caused by parasitic (Wuchereria bancrofti) infections. Our objective was to investigate the spontaneous remission of non-parasitic chyluria. DESIGN AND METHODS: The spontaneous remission of non-parasitic chyluria cases were worked up with diagnostic investigations, clinical assessment and studied in detail with respect to their natural evolution. RESULTS: We present two patients who were evaluated in the nephrology clinic with symptoms of milky urine and painless hematuria. Midnight blood smear was negative for filarial parasites. Urine culture was without mycobacteria. Urine cytology and IgG western blot for cysticercus were negative. Imaging for a lymphatic leak by lymphoscintigraphy was unrevealing. Chyluria resolved spontaneously in both patients. CONCLUSIONS: In our cases, radiologic visualization via lymphoscintigraphy was unrevealing. The patients were managed conservatively and fortunately underwent spontaneous remission marked by the disappearance of chyluria within several months of her initial diagnosis. In our opinion this spontaneous remission could be due to unrevealed lymphatico-renal fistula collapse or sclerosis of lymphatics caused by contrast media.