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

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 cha...

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Main Authors:	Tanaka, Shigeru, Tsuruya, Kazuhiko, Tsuchimoto, Akihiro, Eriguchi, Masahiro, Kitazono, Takanari
Format:	Online
Language:	English
Published:	Oxford University Press 2012
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4432420/

id	pubmed-4432420
recordtype	oai_dc
spelling	pubmed-44324202015-05-27 Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis Tanaka, Shigeru Tsuruya, Kazuhiko Tsuchimoto, Akihiro Eriguchi, Masahiro Kitazono, Takanari Clinical Cases 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. Oxford University Press 2012-10 /pmc/articles/PMC4432420/ /pubmed/26019826 http://dx.doi.org/10.1093/ckj/sfs110 Text en © The Author 2012. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please email: journals.permissions@oup.com http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Tanaka, Shigeru Tsuruya, Kazuhiko Tsuchimoto, Akihiro Eriguchi, Masahiro Kitazono, Takanari
spellingShingle	Tanaka, Shigeru Tsuruya, Kazuhiko Tsuchimoto, Akihiro Eriguchi, Masahiro Kitazono, Takanari Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
author_facet	Tanaka, Shigeru Tsuruya, Kazuhiko Tsuchimoto, Akihiro Eriguchi, Masahiro Kitazono, Takanari
author_sort	Tanaka, Shigeru
title	Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
title_short	Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
title_full	Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
title_fullStr	Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
title_full_unstemmed	Successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
title_sort	successful treatment of massive proteinuria and severe chyluria by inhibition of cholesterol absorption with ezetimibe in a patient with filariasis
description	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.
publisher	Oxford University Press
publishDate	2012
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4432420/
_version_	1613223755300995072

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

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