Chyluria
Chyluria | |
---|---|
Other names | Chylous urine |
Infectious disease |
Chyluria, also called chylous urine, is a medical condition involving the presence of
Chyluria appearance is irregular and intermittent. It may last several days, weeks or even months. There are several factors that trigger Chyluria recurrence.
Signs and symptoms
Once the lymph channels are blocked, one may open into the kidney
Usually the condition is self-limiting and can sometimes lead to complications. If left untreated, chronic chyluria can lead to malnutrition and fat-soluble vitamin deficiency.[3]
Causes
Chyluria is often caused by filariasis due to the parasite Wuchereria bancrofti, a thready nematode which lodges the lymph channels.[2][4] The parasitic infection can lead to obstruction of peripheral lymphatic vessels and increased pressure within the vessels causing collateral flow of the lymph, redirecting the lymph flow from the intestinal lymphatic vessels into the lymphatic vessels of the kidney and ureter.[5] Because of obstruction, subsequent local inflammation of the area leads to dilation of the lymph vessels and the development of a urinary fistulae due to rupture of the lymphatic vessel, which allows for the passage of white blood cells, fat, and fat-soluble vitamins into the urine.[2]
Treatment
Following a low fat and high fluid diet is recommend for managing symptoms.[6]
Medicines that inhibit cholesterol absorption in the small intestine, such as Ezetimibe, may be effective treatments in some patients.[6]
An anti-filarial drug, such as diethylcarbamazine, may be prescribed. Severe damage to lymph channels may require surgery. Sclerotherapy with instillation of 1% of silver nitrate or povidone iodine (2ml of 5% + 8ml distilled water).[3]
References
- ^ "Chronic filariasis". Archived from the original on 2012-02-07. Retrieved 2007-04-13.
- ^ PMID 22669920.
- ^ PMID 27413693.
- PMID 24395870.
- ^ PMID 26019826.