A case of a child with non-parasitic chyluria

비기생충증 원인에 의한 유미뇨 1례

  • Jung, Da Eun (Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Koo, Ja Wook (Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Kim, Sang Woo (Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine) ;
  • Cheong, Hae Il (Department of Pediatrics, Seoul National University College of Medicine, S)
  • 정다은 (인제대학교 의과대학 상계백병원 소아과) ;
  • 구자욱 (인제대학교 의과대학 상계백병원 소아과) ;
  • 김상우 (인제대학교 의과대학 상계백병원 소아과) ;
  • 정해일 (서울대학교 의과대학 소아과학교실)
  • Received : 2005.09.15
  • Accepted : 2005.10.25
  • Published : 2006.03.15

Abstract

Chyluria is the passage of milky urine due to the leakage of lymph into the urinary tract. Chyluria occurs predominantly in adults and is rare in children. We present an unusual case in which a child with proteinuria, hematuria and milky urine was subsequently diagnosed with non-parasitic chyluria. Retrograde cystogram confirmed a lymphatico-calyceal communication. This case showed spontaneous remission. The etiology of this case was not exactly known; however, the prognosis of non-parasitic chyluria (or idiopathic chyluria) is usually very good and the treatment is mostly conservative.

유미뇨는 비뇨기계의 림프계와 정맥계가 누관으로 연결되어 유미(chyle)가 소변으로 배설되는 것을 말한다. 평상시 건강히 지내던 10살된 남아가 딸기 우유빛 소변을 주소로 내원하여 시행한 방광경검사로 우측 요관 입구에서 우유색뇨와 혈액이 분출되는 소견을 보았고, 역행성 신우조영술로 우측신 상부에서 신우-임파역류 소견을 확인하였다. 저자 등은 비기생충증 원인의 유미뇨를 가진 환아에서 보존적 치료법만으로도 자연 치유된 유미뇨 1례를 경험하였기에 이를 보고하고자 한다.

Keywords

References

  1. Lang EK, Redetzki JE, Brown RL. Lymphangiographic demonstration of lymphaticocaliceal fistulas causing chyluria (filariasis). J Urol 1972;108:321-4 https://doi.org/10.1016/S0022-5347(17)60727-4
  2. Rysznyak I, Foldi M, Szabo G. Lymphatics and Lymph circulation, 2nd ed. New York : Pergamon, 1967:785-99
  3. Lai KN, Siu D, Chan KW, Lai FM, Yan KW. The clinical significance of proteinuria in patients with nonparasitic chyluria. Am J Kidney Dis 1986;7:381-5 https://doi.org/10.1016/S0272-6386(86)80086-5
  4. Paik YH, Cho YJ, Koo DS, Ree HI, Shim JC. Studies on the current epidemiological situation of brugian filariasis in endemic areas of Korea. Korean Parasitol 1988;26:255-62 https://doi.org/10.3347/kjp.1988.26.4.255
  5. Pettit J, Sawczuk IS. Use of lymphoscintigraphy in chyluria. Urology 1988;32:367-9 https://doi.org/10.1016/0090-4295(88)90248-8
  6. Haddad MC, al Shahed MS, Sharif HS, Miola UJ. Case report : Investigation of chyluria. Clinical Radiology 1944;49:137-9 https://doi.org/10.1016/S0009-9260(05)83458-0
  7. Ohyama C, Saita H, Miyasato N. Spontaneous remission of chyluria. J Urol 1979;121:316-7 https://doi.org/10.1016/S0022-5347(17)56767-1
  8. Hemal AK, Gupta NP. Retroperitoneoscopic lymphatic management of intractable chyluria. J Urol 2002;167:2473-6 https://doi.org/10.1016/S0022-5347(05)65007-0