Bally S, Demey A, Arrivé L, Rullier C
Service de néphrologie dialyse, centre hospitalier métropole Savoie, place Lucien-Biset, BP 31125, 73011 Chambéry cedex, France.
Service de chirurgie urologique et andrologique, centre hospitalier métropole Savoie, place Lucien-Biset, BP 31125, 73011 Chambéry cedex, France.
Prog Urol. 2016 Dec;26(16):1153-1156. doi: 10.1016/j.purol.2016.09.073. Epub 2016 Oct 27.
Chyluria implies an abnormal communication between the lymphatic system and the urinary tract. It is more frequent in endemic areas of lymphatic filariasis, which constitutes the main cause. Chyluria may mimic a nephrotic syndrome. Diagnosis of chyluria is based on urinary cytological and biocheminal analysis. Localization of the fistula needs medical imaging: cystoscopy, retrograde pyelography, lymphoscintigraphy and more recently magnetic resonance lymphography. Due to frequent spontaneous remissions, traitement can require only dietary measures. In case of malnutrition or clinical complications, sclerotherapy should be rapidly undertaken, before considering surgery of renal lymphatic disconnection.
乳糜尿意味着淋巴系统与泌尿道之间存在异常连通。在淋巴丝虫病的流行地区更为常见，这是其主要病因。乳糜尿可能类似肾病综合征。乳糜尿的诊断基于尿液细胞学和生化分析。瘘管的定位需要医学成像检查：膀胱镜检查、逆行肾盂造影、淋巴闪烁造影以及最近的磁共振淋巴造影。由于常出现自发缓解，治疗可能仅需采取饮食措施。在出现营养不良或临床并发症的情况下，应在考虑进行肾淋巴切断手术之前迅速进行硬化疗法。
