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Filiarial chyluria with nephrotic-range proteinuria and associated hypoalbuminaemia and hypogammaglobulinaemia secondary to bilateral lymphorenal fistulae
  1. Joseph Faraj1,
  2. Julian Mander1,
  3. John R Burnett2,3,
  4. David Prentice4
  1. 1Department of Urology, Royal Perth Hospital, Perth, Western Australia, Australia
  2. 2Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia
  3. 3School of Medicine, University of Western Australia, Perth, Australia
  4. 4Department of Internal Medicine, Royal Perth Hospital, Perth, Western Australia, Australia
  1. Correspondence to Dr Joseph Faraj, joseph.faraj{at}


A 55-year-old man of Indian descent, presented to the emergency department with a 2-year history of passing ‘milky’ white urine, associated with dysuria, urinary retention, bilateral flank pain and 15 kg weight loss. He had migrated to Australia from India at the age of 16, with no overseas travel since, and denied having any fevers, rigours or chills. He was found to have chyluria and nephrotic-range proteinuria with marked hypoalbuminaemia and hypogammaglobulinaemia. Due to his ethnic origin and by diagnostic exclusion, a presumptive diagnosis of filariasis was made. With bilateral lymphorenal disconnection, as definitive management, the patient’s chyluria and proteinuria resolved with restoration of normal plasma protein and immunoglobulin levels.

  • immunology
  • tropical medicine (infectious disease)
  • proteinurea
  • urology
  • urinary and genital tract disorders
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  • Contributors JF was involved in drafting the manuscript. JRB and DP were involved in the conception of the case report. JM, JRB and DP were involved in the critical revision of the manuscript for important intellectual content. All the authors were involved in the final approval of the version to be published and were also involved in the agreement to be accountable for all aspects of the work.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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