Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis

Shigeru Tanaka, Kazuhiko Tsuruya, Akihiro Tsuchimoto, Masahiro Eriguchi, Takanari Kitazono

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria. There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99m-human serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day) was administered during hospitalization. Chyluria was decreased within a few days following the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary tract three months later. In our patient, therapeutic intervention by ezetimibe may have resulted in a reduction of chylous lymph absorption from the intestine and the prevention of mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe may be an effective and safe treatment for this indication, and should be considered when filarial patients present with chyluria and massive proteinuria before employing invasive surgical procedures.

Original languageEnglish
Pages (from-to)449-452
Number of pages4
JournalClinical Kidney Journal
Volume5
Issue number5
DOIs
Publication statusPublished - Oct 1 2012

Fingerprint

Filariasis
Proteinuria
Cholesterol
Lymphoscintigraphy
Technetium
Lymph
Urinary Tract
Serum Albumin
Kidney Pelvis
Therapeutics
Glomerulonephritis
Intestines
Rupture
Hospitalization
Communication
Kidney
Biopsy
Pressure
Ezetimibe
Inhibition (Psychology)

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

@article{fa8154487b56422bae677f8bfb8f9f70,
title = "Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis",
abstract = "We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria. There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99m-human serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day) was administered during hospitalization. Chyluria was decreased within a few days following the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary tract three months later. In our patient, therapeutic intervention by ezetimibe may have resulted in a reduction of chylous lymph absorption from the intestine and the prevention of mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe may be an effective and safe treatment for this indication, and should be considered when filarial patients present with chyluria and massive proteinuria before employing invasive surgical procedures.",
author = "Shigeru Tanaka and Kazuhiko Tsuruya and Akihiro Tsuchimoto and Masahiro Eriguchi and Takanari Kitazono",
year = "2012",
month = "10",
day = "1",
doi = "10.1093/ckj/sfs110",
language = "English",
volume = "5",
pages = "449--452",
journal = "CKJ: Clinical Kidney Journal",
issn = "2048-8505",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis

AU - Tanaka, Shigeru

AU - Tsuruya, Kazuhiko

AU - Tsuchimoto, Akihiro

AU - Eriguchi, Masahiro

AU - Kitazono, Takanari

PY - 2012/10/1

Y1 - 2012/10/1

N2 - We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria. There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99m-human serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day) was administered during hospitalization. Chyluria was decreased within a few days following the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary tract three months later. In our patient, therapeutic intervention by ezetimibe may have resulted in a reduction of chylous lymph absorption from the intestine and the prevention of mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe may be an effective and safe treatment for this indication, and should be considered when filarial patients present with chyluria and massive proteinuria before employing invasive surgical procedures.

AB - We describe a case of filariasis presenting with severe chyluria and nephrotic-range proteinuria. There were no obvious findings of glomerulonephritis in the renal biopsy. Technetium-99m-human serum albumin (Tc-99m-HSA) lymphoscintigraphy revealed the presence of communications between lymphatic channels and the urinary tract. Ezetimibe (10 mg/day) was administered during hospitalization. Chyluria was decreased within a few days following the administration of ezetimibe. Moreover, a remission was obtained from nephrotic-range proteinuria. Tc-99m-HSA lymphoscintigraphy showed a reduction of lymph flow to the urinary tract three months later. In our patient, therapeutic intervention by ezetimibe may have resulted in a reduction of chylous lymph absorption from the intestine and the prevention of mucosal rupture into the renal pelvis and calyx via reduced intralymphatic pressure. Ezetimibe may be an effective and safe treatment for this indication, and should be considered when filarial patients present with chyluria and massive proteinuria before employing invasive surgical procedures.

UR - http://www.scopus.com/inward/record.url?scp=84867409482&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84867409482&partnerID=8YFLogxK

U2 - 10.1093/ckj/sfs110

DO - 10.1093/ckj/sfs110

M3 - Article

AN - SCOPUS:84867409482

VL - 5

SP - 449

EP - 452

JO - CKJ: Clinical Kidney Journal

JF - CKJ: Clinical Kidney Journal

SN - 2048-8505

IS - 5

ER -