Chyluria is a rare clinical entity defined by the presence of chyle in the urine, classically presenting as milky or cloudy urine. While typically associated with parasitic infections such as Wuchereria bancrofti in endemic regions, non-parasitic causes are less common and diagnostically challenging. We report the case of a 56-year-old male presenting with milky urine, dysuria, urinary hesitancy, and rectal discomfort. Urine triglyceride level was found to be >525 mg/dL (reference range <10 mg/dL). An extensive infectious and parasitic workup was negative. Renal biopsy revealed minimal change disease (MCD), a highly unusual finding in adult-onset chyluria. Although MCD does not cause chyluria, coexisting disease can contribute to urinary protein loss. This case highlights the importance of maintaining a broad differential diagnosis when evaluating urinary discoloration and emphasizes the rare intersection between glomerular disease and lymphatic-urinary communication. Early recognition of atypical presentations is essential to guide appropriate evaluation and prevent complications associated with chronic chyle loss.
Abstract
Case Reports
Journal Article
eng
41122578
McPherson, Regina J., et al. "Chyluria With Coexisting Minimal Change Disease: an Uncommon Clinical Association." Cureus, vol. 17, no. 9, 2025, pp. e92800.
McPherson RJ, Santos Rivera JR, Manocchio NV, et al. Chyluria With Coexisting Minimal Change Disease: An Uncommon Clinical Association. Cureus. 2025;17(9):e92800.
McPherson, R. J., Santos Rivera, J. R., Manocchio, N. V., Sharma, M., & Fonarov, I. (2025). Chyluria With Coexisting Minimal Change Disease: An Uncommon Clinical Association. Cureus, 17(9), e92800. https://doi.org/10.7759/cureus.92800
McPherson RJ, et al. Chyluria With Coexisting Minimal Change Disease: an Uncommon Clinical Association. Cureus. 2025;17(9):e92800. PubMed PMID: 41122578.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR
T1 - Chyluria With Coexisting Minimal Change Disease: An Uncommon Clinical Association.
AU - McPherson,Regina J,
AU - Santos Rivera,Juan Ramon,
AU - Manocchio,Nicholas V,
AU - Sharma,Mehak,
AU - Fonarov,Ilya,
Y1 - 2025/09/20/
PY - 2025/07/01/received
PY - 2025/09/20/accepted
PY - 2025/10/22/medline
PY - 2025/10/22/pubmed
PY - 2025/10/22/entrez
KW - chyluria
KW - cloudy urine
KW - lymphatic stasis
KW - milky urine
KW - minimal change disease (mcd)
SP - e92800
EP - e92800
JF - Cureus
JO - Cureus
VL - 17
IS - 9
N2 - Chyluria is a rare clinical entity defined by the presence of chyle in the urine, classically presenting as milky or cloudy urine. While typically associated with parasitic infections such as Wuchereria bancrofti in endemic regions, non-parasitic causes are less common and diagnostically challenging. We report the case of a 56-year-old male presenting with milky urine, dysuria, urinary hesitancy, and rectal discomfort. Urine triglyceride level was found to be >525 mg/dL (reference range <10 mg/dL). An extensive infectious and parasitic workup was negative. Renal biopsy revealed minimal change disease (MCD), a highly unusual finding in adult-onset chyluria. Although MCD does not cause chyluria, coexisting disease can contribute to urinary protein loss. This case highlights the importance of maintaining a broad differential diagnosis when evaluating urinary discoloration and emphasizes the rare intersection between glomerular disease and lymphatic-urinary communication. Early recognition of atypical presentations is essential to guide appropriate evaluation and prevent complications associated with chronic chyle loss.
SN - 2168-8184
UR - https://www.unboundmedicine.com/prime/citation/41122578/Chyluria_With_Coexisting_Minimal_Change_Disease:_An_Uncommon_Clinical_Association.
DB - PRIME
DP - Unbound Medicine
ER -
