Summary :
Summary :
Chyluria is a rare medical condition characterized by the presence of chyle in the urine, via an abnormal lymphatic connection, which causes the urine to appear milky white.
Chyle is a milky substance composed of lymphatic fluid and chylomicrons formed in the small intestine during the digestion of fatty foods.
Most cases are secondary to infection by Wuchereria parasites. However, in Western countries, non-parasitic causes are most common.
The main symptom is thin, milky, possibly foamy urine, it is usually associated with urinary tract infection, blood in the urine and pain in the kidneys.
Treatment for chyluria will depend on the cause.
Urine from a patient with filarial chyluria (Source).
Chyluria is a condition characterized by the presence of fat and lymph in the urine, while in lymphuria only lymph is present.
Chyluria occurs when the lymphatic system is damaged or not functioning as it should and there is abnormal communication between the lymph vessels and the urinary systems.
It is generally classified as parasitic (parasitic infection) or non-parasitic based on its etiopathogenesis
Note : Whatever the cause, if lymphatic drainage from the bowel is obstructed, the lymphatic vessels dilate and may rupture and flood the urinary tract.
The main signs and symptoms of chyluria include:
Note : The patient may remain completely asymptomatic in some cases.
To diagnose chyluria, doctors ask about symptoms, do an exam, test urine and blood, and order x-rays
◉ Urine tests: A post-prandial urine sample is recommended. It can be characterized by:
◉ Blood tests: blood hypereosinophilia, filarial antigen, emission of nocturnal microfilariae in the circulating blood
◉ Imaging tests: May include CT scan, lymphangiogram, MRI, X-ray, intravenous urography, retrograde pyelography, or ultrasound. These tests can be useful tools to find the cause of the obstruction and localize the chylo-urinary leak
◉ Laparoscopy: A thin rod with a camera attached is passed through a small incision in your abdomen to determine the source of lymphatic leakage.
Treatment for chyluria depends on its cause. It may include :
◉ Diet change
◉ Drugs
◉ Minimally invasive
◉ Invasive treatment
In some situations, the doctor may recommend more invasive procedures, such as surgery:
Chyluria goes away without treatment (up to 50% of cases). However, It can sometimes cause problems such as vitamin deficiencies, cachexia, hypoproteinaemia and malnutrition.
The normal color of the urine is clear to pale yellow. Any changes like white, brown, or red color are considered abnormal. But certain medicines or foods can change the color such as beets, blackberries and fava beans can turn urine pink or red, for example.
Although chyluria is not life-threatening, its symptoms may require hospitalization for improvement.
The obstruction of lymph flow and rupture of lymphatic vessels into the renal pelvis, ureters, bladder, or urethra.
Parasitic chyluria is mainly (95%) caused by Wuchereria bancrofti. It is an unusual manifestation of lymphatic filariasis reported mainly from South Asian countries.
Sources