A Rare Case of Chylous Ascites and Chyluria in an Adult Nephrotic Syndrome with Focal Segmental Glomerulosclerosis
Songkiat Lewsuwan MD*, Talerngsak Kanjanabuch MD*, Yingyos Avihingsanon MD*, Kearkiat Praditpornsilpa MD*, Somchai Eiam-Ong MD*
Affiliation : * Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital
The authors report the first case of chylous ascites and chyluria in a 65-year-old Thai women with nephrotic syndrome due to focal segmental glomerulosclerosis (FSGS), tip variant. She presented with gener- alized edema and abdominal discomfort. Abdominal paracentesis revealed milky white fluid. Chylous ascites was confirmed. Abdominal and thoracic computed tomography did not show any cause of chylous ascites and chyluruia. Lymphoscintigraphy could not demonstrate lymph flow obstruction and connection between lym- phatic pathway and KUB system. Those could have explained the chylous ascites or chyluria. Hypoalbumin- emia-induced bowel edema may predispose to change the permeability of mucosal or serosal lymphatics. This could result in chylous ascites but the cause of chyluria could not be determined in this case.
Keywords : Chylous ascites, Chyluria, Nephrotic syndrome, FSGS
