As Milky as It Can Get; Chyluria: A Case Report and Review of Literature

Filariasis is an important public health problem in India. Extralymphatic manifestation of filariasis includes chyluria or passage of intestinal lymph or chyle into urine imparting a milky-white color, is an important manifestation of renal involvement. A young woman residing in a filaria endemic region, presented with persistent chyluria of 3-month duration. She did not have any features of nephrotic or nephritic syndrome or features of connective tissue disease. After routine hematological, biochemical, serological, and urinalysis, nephrotic range proteinuria and lipiduria were confirmed, and kidney biopsy was performed. Kidney biopsy showed an elongated parasitic sheathed structure with multiple basophilic nuclei spread along the length of the tail, suggestive of microfilaria, in capillaries of a single glomerulus; immunofluorescence was negative for immunoglobulin (Ig) A, IgM, IgG, C3, C1q, kappa, and lambda. She was given antifilarial drug and chyluria promptly subsided. The complex evaluation and management of chyluria have been discussed.