Poitou Caroline, Kheder-Elfekih Rania, Djebbar Morad, Perreira Paz, Deray Gilbert, Izzedine Hassane
Service de néphrologie, hôpital de la Pitié-Salpétrière, Paris, France.
Nephrol Ther. 2009 Dec;5(7):642-7. doi: 10.1016/j.nephro.2009.06.003. Epub 2009 Jul 23.
A patient is admitted in hospital to explore a nephrotic proteinuria associated with milky urine. This is explained by a chyluria (presence of lymphatic fluid in the urines), which is due to a pyelolymphatic fistula probably linked to a lymphatic filariasis. Usually, the diagnosis of chyluria can be confirmed by the presence of urinary chylomicrons. The presence of an urinary-lymphatic fistula can be proved by different techniques (cystoscopy, retrograde pyelography, uroscanner, lymphoscintigraphy). The main cause of chyluria is parasitic infections (filarial infection, echinococcus, cysticercosis), but other causes can be found, such as granulomatosis, neoplasia, lymphatic malformations, or sequela of surgery or traumatism. Chyluria is one of the causes of post-nephronic nephrotic proteinuria. Depending on the impact of the chyluria for the patient, there will either be no treatment, or a treatment by sclerotherapy or surgery.
一名患者因探究与乳糜尿相关的肾病性蛋白尿而入院。这是由乳糜尿（尿液中存在淋巴液）所解释的，乳糜尿是由于肾盂淋巴瘘可能与淋巴丝虫病有关。通常，乳糜尿的诊断可通过尿中乳糜微粒的存在来证实。尿-淋巴瘘的存在可通过不同技术（膀胱镜检查、逆行肾盂造影、尿路扫描仪、淋巴闪烁显像）来证实。乳糜尿的主要原因是寄生虫感染（丝虫感染、棘球蚴病、囊尾蚴病），但也可发现其他原因，如肉芽肿病、肿瘤、淋巴管畸形或手术或外伤后遗症。乳糜尿是肾后性肾病性蛋白尿的原因之一。根据乳糜尿对患者的影响，要么不进行治疗，要么采用硬化疗法或手术治疗。
