Preterm with milky urine | Pediatric Oncall Journal

IMAGES IN CLINICAL PRACTICE

Preterm with milky urine

Anshika Taiwade¹, Shweta Anand¹, Rashmi Vishwakarma¹, Rajeev Sharma¹, G.C Bhatt².

¹Department of Pediatrics, LN Medical College and JK Hospital, Bhopal, Madhya Pradesh, India,
²Department Of Paediatric Nephrology, AIIMS, Bhopal, Madhya Pradesh, India.

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Why this article important?

To know the condition called benign crystaluria leading to milky urine in preterm newborn male and how it can be treated with. Crystalluria can be one of the cause of milky urine in preterm.Crystalluria is considered often as a benign condition and may represent Dehydration. Which in newborns can be corrected by encouraging breast feeding.. Other causes of Passage of milky urine: A. Chyluria :Chyluria is the excretion of chyle from the urinary tract . Chyle is defined as the lymphatic fluid in the intestinal lacteals that contains absorbed fat in the form of chylomicrons, giving the intestinal lymph a milky appearance.Chyluria is associated with abnormal retrograde or lateral flow of lymph from the intestinal lymphatics of the kidney, ureter or bladder, allowing chylous material to be discharged into the urinary collecting system . B.Complication of central venous catheterization: which include perforation of the vessel walls and extravasation of the infusate into a body cavity. Perforation of the renal pelvis is a very rare complication, reported in few cases of neonates with abdominal malformation . In this situation the milkiness is due to the presence of lipid in the total parenteral nutrition (TPN) extravasated, which is mixed with the urine.

Summary of article

A primigravida mother delivered a preterm (35±2 weeks) male baby by Emergency LSCS (Severe oligohydramnios) with birth weight of 2.28kg.Baby required no resuscitation and shifted tomother side after routine care. Baby developed neonatal jaundice on 60 hours of life for which phototherapy started. Neonatal hyperbilirubenemia resolved within 24 hours and baby was discharge on 6th day of life. On 10th day mother came with complain of passing turbid urine (FIGURE 1) and significant weight loss (300gms). We hospitalized the baby and started initial management. Initial management of urine revealed amorphous amount of calcium oxalate crystal with no pus cell. septic screening were negative and urine culture showed commensal pathogen. Radioimaging done which was normal, RFT were normal. Urine calcium/creatinine ratio was high and urine chylomicron was negative. With proper counseling regarding Breast feeding, Hydration improved and urine became clear

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