title: A rare case of chylous ascites and chyluria in an adult nephrotic syndrome with focal segmental glomerulosclerosis.
abstract: 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 generalized 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 lymphatic pathway and KUB system. Those could have explained the chylous ascites or chyluria. Hypoalbuminemia-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.
authors.affiliation: Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand.
authors.forename: Songkiat
authors.initials: S
authors.lastname: Lewsuwan
authors.forename: Talerngsak
authors.initials: T
authors.lastname: Kanjanabuch
authors.forename: Yingyos
authors.initials: Y
authors.lastname: Avihingsanon
authors.forename: Kearkiat
authors.initials: K
authors.lastname: Praditpornsilpa
authors.forename: Somchai
authors.initials: S
authors.lastname: Eiam-Ong
mesh_terms: D000368:Aged; D002913:Chyle; D002915:Chylous Ascites / Q000178:diet therapy / Q000209:etiology*; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000473:pathology*; D006801:Humans; D009404:Nephrotic Syndrome / Q000150:complications* / Q000473:pathology; D013785:Thailand; D014556:Urine