Chylurie révélée par un « pseudo-syndrome néphrotique » : démarche diagnostique et thérapeutique

Chyluria implies an abnormal communication between the lymphatic system and the urinary tract. It is more frequent in endemic areas of lymphatic filariasis, which constitutes the main cause. Chyluria may mimic a nephrotic syndrome. Diagnosis of chyluria is based on urinary cytological and biocheminal analysis. Localization of the fistula needs medical imaging: cystoscopy, retrograde pyelography, lymphoscintigraphy and more recently magnetic resonance lymphography. Due to frequent spontaneous remissions, traitement can require only dietary measures. In case of malnutrition or clinical complications, sclerotherapy should be rapidly undertaken, before considering surgery of renal lymphatic disconnection.