What disease is milky white urine

The urine is milky white. This condition is medically called chyluria. This condition means that there is a problem with the absorption of protein by the renal calyx. In severe cases, there will be severe and recurrent renal colic, and the patient will lose weight. This disease is more common in adults, and the causes are divided into non-parasitic and parasitic.

Chylous urine

Details

Chyluria is caused by the backflow of chyle into the urine. It appears milky white to varying degrees and the urine chyle test may be positive. If it contains more blood, it is called chylous hematuria. The characteristic of chyluria is that the urine is turbid like milk, or like swill or soy milk, hence the name. The highest age of onset of chyluria is between 30 and 60 years old. The cause of chyluria is currently believed to be thoracic duct obstruction and local lymphatic inflammatory damage, which leads to changes in lymphatic dynamics, lymph entering the urinary tract and causing chyluria. Chyluria is classified into mild, moderate, and severe according to its severity. Mild symptoms include intermittent chyluria, no chylous clot formation, no weight loss, and retrograde pyelography showing involvement of a single renal calyx; moderate symptoms include intermittent or persistent chyluria, occasional chylous clots, no weight loss, and retrograde pyelography showing involvement of both renal calyces; severe symptoms include persistent chyluria, chylous clots, weight loss, and retrograde pyelography showing involvement of most renal calyces. If chyluria is not relieved or effectively treated, it may lead to recurrent renal colic, nutritional problems caused by protein loss, and immunosuppression caused by lymphocytic urine. Treatment includes targeting the pathogen, traditional Chinese medicine, renal pelvic perfusion, extracorporeal shock wave and surgical treatment.

High incidence group

People aged 30 to 60

Common causes

Caused by filariasis, abdominal tuberculosis, tumor, chest and abdominal trauma or surgery

Common symptoms

Turbid urine like milk, swill, or soy milk; mild is intermittent, moderate is intermittent or continuous, severe is continuous, with chylomicron clots, and weight loss

Causes and common diseases

There are two main causes of chyluria:

1. Non-parasitic

For example, tuberculosis, malignant tumors, etc. widely invade the retroperitoneal lymphatic vessels and lymph nodes, causing destruction or obstruction, local lymphatic inflammation and damage, leading to changes in lymphatic dynamics, lymph fluid entering the urinary tract, and chyluria. Relatively rare.

2. Parasitic

The vast majority are caused by filariasis. It is now believed that chyluria is a common complication of Bancroftian filariasis and can occur in both the acute and chronic stages. It is caused by filarial worms entering the lymphatic vessels, causing damage to the lymphatic vessels. Domestic data show that Malayan filariasis may also cause chyluria, hydrocele, spermatic cord inflammation and other intrascrotal complications, but the number is very rare.

Detailed classification of chyluria causes :

1. Filariasis

Chylous urine caused by filariasis is one of the main symptoms of chronic filariasis infection and is the most common cause of chyluria. Filaria repeatedly causes lymphangitis in the lymphatic system, resulting in massive proliferation of fibrous tissue and extensive obstruction of the abdominal lymphatic channels and thoracic duct. Chylous urine caused by filarial worms often occurs intermittently. Overwork, pregnancy, and childbirth are often the triggering factors, but it may also exist continuously.

2. Abdominal tuberculosis

Extensive abdominal tuberculosis can affect the retroperitoneal lymphatics in the abdomen and flow back into the urinary tract lymphatics, causing chyluria, and is often accompanied by renal tuberculosis. Abdominal tuberculosis and renal tuberculosis are often secondary to pulmonary lymph node tuberculosis.

3. Tumor

Malignant tumors that originate or metastasize to the abdominal cavity, retroperitoneum, mediastinum, etc. can compress and block the abdominal lymphatic channels or thoracic duct and cause chyluria. Lymphoma is the most common clinical disease. Mediastinal tumors and central lung cancer can also cause chyluria, sometimes accompanied by chylothorax.

4. Thoracic or abdominal trauma or major surgery

Due to damage to the abdominal lymphatics or thoracic duct. The medical history can often aid in the diagnosis.

5. Primary lymphatic diseases

Rarely, the disease occurs in childhood due to congenital malformation of the thoracic duct or extensive congenital hypoplasia of the lymphatic vessels.

6. Other causes

Diseases such as pyelonephritis, glomerulonephritis, pregnancy compression, malaria, etc. can occasionally cause chyluria. There are only a few case reports in the literature.