Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0033687 (proteinuria)
 24,015 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A clinical case of clinostatic chyluria of unknown non-parasitic aetiology, is reported. Ascending pyelography showed the presence of lymphatic communications between right renal pelvis and homolateral lumbo-aortic lymph nodes. Aetiology, pathogenesis, prognosis and diagnostic tools of use in the syndrome are discussed. The problem of the possible lymphatic origin of benign proteinuria, in relation to anatomic considerations and to quality and quantity resemblances between individual protein fractions in chyluria and benign proteinuria encountered in the present case, is also discussed. In order to clarify the problem, emphasis is laid on the advisability of simultaneously studying urinary protein composition in postural chyluria and lipid composition in benign proteinuria.
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PMID:[Notes on a case of clinostatic chyluria]. 125 May 7

Five patients with heavy proteinuria and nonparasitic chyluria due to congenital abnormalities of the lymphatic system are described. Renal biopsies confirmed the clinical suspicion of an underlying glomerulonephritis. The coexistence of glomerulonephritis and chyluria in these patients was thought coincidental. Tests of value in detecting a concomitant glomerulonephritis in these patients with chyluria include urinary RBC morphology, quantitation of 24-hour urinary protein, and immunoelectrophoresis of serum and urinary proteins. Contrary to previous reports, the present study suggests that chyluria does not produce proteinuria of enough severity to cause hypoproteinemia.
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PMID:The clinical significance of proteinuria in patients with nonparasitic chyluria. 370 95

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.
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PMID:Nontropical chyluria secondary to massive mesenteric adenitis. Case report with metabolic and immunologic studies. 647 96

Chyluria is the passage of chylus into urine resulting in fistulization through the lymphatic system and the urinary system. This rare condition is usually caused by filaria infestation or malformations, neoplasia or trauma. We report a case of a 18-year-old man. The patient presented milky urine which had appeared after angiography following minor leg trauma. Physical examination revealed asymmetry of the face and cutaneous dyschromia. Blood tests revealed hypogammaglobulinemia and altered CD4/CD8 ratio (0.6). Urine tests showed proteinuria (30 mg/dl), lipiduria (triglycerides 750 mg/dl) and density of 1025. Renal function was normal. Abdomen computed tomography and urography were normal. Cystoscopy revealed the presence of milky urine in the bladder and selective catheterization revealed that the origin was the right ureter alone. Ascendent pyelography did not reveal any malformation of the urinary tract; but after this the chyluria spontaneously disappeared. The patient was rehospitalized 3 months later for recurrence. Lymphography was then performed and revealed a dilated lymphatic network with minute lacunar images projecting into the right kidney. Chyluria again disappeared spontaneously and recurred sporadically over the next two years in a patient who remained in good physical condition. The etiology of chyluria in a patient without filaria infestation is problematic, particularly when the most common causes (tuberculosis, neoplasia, trauma) are excluded as in our case. The asymmetry of the face, together with cutaneous dyschromia and the presence of a subarachnoidea cyst in the right temporal region suggested our patient had multiple congenital malformations.
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PMID:[Intermittent chyluria in a young man]. 872 1

Proteinuria is commonly observed in patients with chyluria due to Bancroftian filariasis. However, whether or not hypoalbuminemia is caused by chyluria alone is still a matter of debate. This is because various forms of glomerulonephritis are complicated in such patients. Herein, we report a case we have recently encountered. A 72-year-old male was admitted to our division for further evaluation of nephrotic syndrome. He was from the Southernmost part of Japan, where Bancroftian filariasis has been epidemic, and had developed persistent chyluria over a period of nearly 50 years. There was no other past history of illness except for diabetes mellitus(DM) pointed out 3 months prior to admission. The physical and laboratory examinations on admission fulfilled the diagnostic criteria for nephrotic syndrome. Lymphoscintigraphy showed an intense tracer accumulation in both kidneys. A renal biopsy was performed. At the light microscopic level, the glomeruli looked normal. Edema of the tubulointerstitium was noted. At the electron microscopic level, effacement of podocyte foot processes was not observed. Immunofluorescent study did not show glomerular deposition of immunoglobulins and complements. He also had persistent microscopic hematuria. Automated urinary sediment analysis by real-time confocal scanning laser microscopy revealed red blood cells of the non-glomerular type. Taken together, these findings strongly indicated that hypoalbuminemia of this patient was caused by chyluria alone. In conclusion, a report of the present case provides strong evidence that hypoalbuminemia of a patient with Bancroftian filariasis could be caused by chyluria alone.
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PMID:[A case report of chronic chyluria probably due to Bancroftian filariasis, which showed hypoproteinemia]. 1128 Feb 12

A 27 year old patient presented with a sudden acute illness showing right flank pain, milky urine, nephrotic range proteinuria, erythrocyturia and leukocyturia in the urinary sediment with a negative leukocyte test stick. The proof of a pronounced hypertriglyceriduria led to the diagnosis of Chyluria. The lymphangiogram confirmed the presence of a retroperitoneal lymphatic dysplasia with evidence of communication with the right renal pelvis on the CT-lymphogram. Chyluria is generally the result of parasitic infection and is extremely rare in Europe. In the presence of symptoms including milky urine, proteinuria and leukocyturia in the urinary sediment and a negative urine leukocyte stick test and absence of infectious signs, chyluria must be suspected. The diagnosis should be substantiated through proof of hypertriglyceriduria and confirmed by lymphangiography.
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PMID:[A rare cause of nephrotic syndrome in a young woman with flank pain, milky urine and leukocyturia]. 1197 3

A 21- year-old lady presented with chyluria, severe malnutrition, secondary amenorrhea, profound hypoalbuminemia, heavy proteinuria and renal tubular abnormalities suggestive of Type IV renal tubular acidosis. No particular cause for chyluria could be ascertained. She was successfully treated with an injection of 2% silver nitrate into the left ureter and urinary bladder. She continues to be well after 15 years of follow-up.
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PMID:Successful treatment of chyluria, glomerular and tubular abnormalities in a young lady with silver nitrate instillation. 1749

A 38-years of Bangladeshi woman with a post medical history of treated Bancroftian Filariasis ten years before, presented with chyluria and heavy proteinuria. Percutaneous renal biopsy was consistent with membranous glomerulonephritis. The patient was treated with diethylcarbamazinc (DEC), and later, with azathioprine and prednisolone for the nephrosis. The chyluria disappeared with treatment, but recurred four months later, despite persistent drug therapy. The proteinuria dropped to 2.4 g and 0.2 g/24 hours at two and twelve weeks respectively. After two years of follow-up, the chyluria persisted but the proteinuria remained below 0.2g/24 hours, while plasma proteins remained within normal limits. The patient maintained stable body weight, good general health status, stable renal functions and normal lipid and hepatic profiles. The numerous investigations carried out to elucidate the etiology of the chyluria were not rewarding. The conservative approach for the management of chyuria adopted in this patient seems to be appropriate.
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PMID:Membranous Glomerulonephritis in a Patient Presenting with Chyluria, Probably due to Filariasis: How far should we investigate? 1821 28

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.
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PMID:[Chyluria presenting as milky urine and nephrotic-range proteinuria and milky urine: chyluria or glomerulopathy? Case report and literature review]. 1963

Chyluria results from an abnormal connection between lymphatic bed and urinary tract, causing lymph leakage into the urine. The clinical picture often begins with the appearance of cloudy, milky urines accompanied by monolateral flank pain, malnutrition, weight loss and weakness. We report a case of chyluria that occurred in a young woman who was referred to our unit for nephrotic-range proteinuria. Before performing a renal biopsy, we found that urine analysis demonstrated a massive lipiduria. Therefore, we collected urine samples from each kidney with a selective ureteral catheterization, demonstrating a monolateral source of lipids and proteins. We suspended the renal biopsy and performed a lymphography that showed an inherited lymphangioma on the left lumbar lymphatic bed. Sclerosing solution instillation, renal pedicle lymphatic disconnection or laser therapy are invasive therapeutical options that may cause severe adverse effects. Instead of these procedures, a conservative therapy based on a low-fat diet supplemented with medium-chain triglycerides was chosen. This dietetic schedule was followed by complete resolution of proteinuria and lipiduria. The patient progressively gained body weight and improved quality of life. No relapses were observed after 3 years of follow-up. This case emphasizes the possible role of a noninvasive therapeutical option for patients with chyluria.
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PMID:Looking at appearance of urine before performing a renal biopsy in nephrotic syndrome. 2160 20


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