Nontropical chyluria secondary to massive mesenteric adenitis. Case report with metabolic and immunologic studies.

This report describes metabolic and immunologic studies in a 17-year-old white man with nontropical chyluria secondary to massive mesenteric adenitis. Numerous red cells and mature lymphocytes were observed in the urine, and cystoscopic examination demonstrated chyle emanating from both ureteral orifices. Retrograde studies demonstrated pyelolymphatic backflow, and lymphangiography revealed prominent lymphaticocaliceal communications. Twenty-four-hour urinary studies showed proteinuria and lipiduria, which decreased after lymphangiography and a low-fat diet. Skin tests for delayed hypersensitivity were nonreactive, the lymphocyte count was decreased, and lymphocyte responses to phytohemagglutinin and pokeweed mitogen were normal. Chyluria ceased after interruption and ligation of the renal and mesenteric lymphatics.