Information obtained from continuous urinalysis of patients with chyluria

Abstract

Chyluria is the principal sign that suggests a fistula between the urinary tract and a lymphatic vessel. The present report is based on information obtained from the continuous urinalysis of a male patient in his 70s with a confirmed fistula between the urinary tract and a lymphatic vessel. Urinary sediments from all urine samples obtained during hospitalization contained approximately 90% lymphocytes, suggesting the long-term persistence of a fistula between the urinary tract and the lymphatic vessel. All first morning fasting urine samples had a transparent pale-yellow appearance, with chyluria appearing after meals. Thus, we confirmed that chyluria was affected by food consumption. Regarding the correlation between the protein urine/Cr ratio and the urinary lymphocyte count, the protein urine/Cr ratio was in the range of 0.41–0.82 g/gCr when the urinary lymphocyte count was ≤ 1–4 per HPF (high power field; HPF), and the ratio was in the range of 1.63–5.25 g/gCr when the urinary lymphocyte count was ≥ 5–9 per HPF. Thus, we hypothesized that the protein urine/Cr ratio was affected by the quantity of the mixture of lymphatic liquid because the ratio was linked to the increases and decreases in the urine lymphocyte count. Therefore, we infer that it is important to suspect a fistula between the urinary tract and a lymphatic vessel on the basis of an increased urine lymphocyte count and the correlation between the protein urine/Cr ratio and the urine lymphocyte count, which is not affected by the appearance of the urine.