Chyluria in non-filarial endemic areas: an internist's perspective.

A 60-year-old Chinese woman presented with intermittent, painless, gross haematuria and subsequently complained of persistent milky urine. The diagnosis of chyluria was confirmed after cystoscopy demonstrated ureteric milky fluid discharge which had elevated levels of triglycerides. The patient did not travel to filarial endemic areas and her serum circulating filarial antigen was negative. Intravenous pyelography with CT of the abdomen did not reveal any masses or obstruction. It was determined that her chyluria was non-parasitic in origin and her symptoms improved with a low fat, high-protein diet. However, her chyluria recurred 1 year later, resulting in hypoalbuminaemia and proteinuria. Her symptoms resolved and her albumin levels normalised with adherence to dietary modifications.