Membranous Glomerulonephritis in a Patient Presenting with Chyluria, Probably due to Filariasis: How far should we...

A 38-years of Bangladeshi woman with a post medical history of treated Bancroftian Filariasis ten years before, presented with chyluria and heavy proteinuria. Percutaneous renal biopsy was consistent with membranous glomerulonephritis. The patient was treated with diethylcarbamazinc (DEC), and later, with azathioprine and prednisolone for the nephrosis. The chyluria disappeared with treatment, but recurred four months later, despite persistent drug therapy. The proteinuria dropped to 2.4 g and 0.2 g/24 hours at two and twelve weeks respectively. After two years of follow-up, the chyluria persisted but the proteinuria remained below 0.2g/24 hours, while plasma proteins remained within normal limits. The patient maintained stable body weight, good general health status, stable renal functions and normal lipid and hepatic profiles. The numerous investigations carried out to elucidate the etiology of the chyluria were not rewarding. The conservative approach for the management of chyuria adopted in this patient seems to be appropriate.