Mendu Damodara Rao, Sternlicht Hillel, Ramanathan Lakshmi V, Pessin Melissa S, Fleisher Martin, Dalbagni Guido, Jaimes Edgar A, Kaltsas Anna, Glezerman Ilya G
Department of Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, United States.
Division of Nephrology, Department of Medicine, Lenox Hill Hospital, New York, NY, United States.
Clin Biochem. 2017 Oct;50(15):886-888. doi: 10.1016/j.clinbiochem.2017.05.002. Epub 2017 May 4.
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.
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.
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.
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.
乳糜尿是一种尿液中出现乳糜的病症。该疾病在东南亚国家最为普遍，主要由寄生虫（班氏吴策线虫）感染引起。我们的目的是研究非寄生虫性乳糜尿的自然缓解情况。
对非寄生虫性乳糜尿病例的自然缓解情况进行诊断性检查、临床评估，并详细研究其自然病程。
我们报告了两名在肾病门诊接受评估的患者，他们有乳糜尿和无痛性血尿症状。夜间血涂片未发现丝虫寄生虫。尿培养未发现分枝杆菌。尿液细胞学检查和囊尾蚴IgG免疫印迹均为阴性。通过淋巴闪烁显像检查淋巴漏的影像学检查未发现异常。两名患者的乳糜尿均自行缓解。
在我们的病例中，通过淋巴闪烁显像进行的影像学检查未发现异常。患者接受了保守治疗，幸运的是在初次诊断后的几个月内乳糜尿消失，实现了自然缓解。我们认为这种自然缓解可能是由于未发现的淋巴管-肾瘘塌陷或造影剂导致的淋巴管硬化。
