Résumé
Chyluria is the passage of milky urine composed of albumin, chylomicron, and fibrin in various proportions due to the leakage of lymph into the urinary tract as a result of communication between the lymphatics and the urinary system. Intermittent mild proteinuria and hematuria may be found at routine urinalysis, The conventional diagnostic approach involves confirmation of chyle in urine and the demonstration of lymphaticourinary fistulae by radiological study. It occurs predominantly in adults and is rare in children, We present an unusual case of a four-year-old male child with proteinuria, hematuria and milky urine which was subsequently diagnosed as idiopathic non-parasitic chyluria with spontaneous remission. The child recovered with dietary management for about five weeks after starting a low-fat, high-fiber diet
Résumé
Alkaptonuria is a rare inborn metabolic disorder with Mendelian recessive inheritance characterized by triad of homogentisic aciduria, arthritis and ochronosis. The incidence is one per 0.25 - 1 million persons. A 17-month- old female child of non-consanguineous parents presented with darkening of clothes / diapers moistened with urine when left unwashed for hours. There was no other medical problem in the family. Physical examination including joints revealed a healthy child with normal growth parameters. There was no pigmentation of the sclera, conjunctiva and cornea and ear cartilage. Her urine appeared normal colored on voiding. However, it turned black on standing at room temperature. Regular laboratory investigations were within normal range and skeletal survey showed no degenerative changes. Urine for alkalization and reducing substances was positive. Urine organic acidogram-chromatogram study showed [1137.87%] 2845-fold increase in homogentisic acid and confirmed the diagnosis of alkaptonuria. She was started on Vitamin C [0.5 gm twice a day]. She is now asymptomatic over a 13-month follow-up period