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Ann Saudi MedAnn Saudi MedAnnals of Saudi Medicine0256-49470975-4466King Faisal Specialist Hospital and Research Centre 10.5144/0256-4947.2013.202asm-2-202CommentsChyluria: a mimicker of nephrotic syndrome Al-Mendalawi Mahmood Dhahir From the Pediatrics, Al-Kindy College of Medicine, Baghdad University, Baghdad, IraqCorrespondence: Prof. Mahmood Dhahir Al-Mendalawi, Pediatrics, Al-Kindy College of Medicine, Baghdad University, P.O. Box 55302, Baghdad Post Office, Baghdad 1111 Iraq, mdalmendalawi@yahoo.comMar-Apr 2013 33 2 202 203 Copyright © 2013, Annals of Saudi Medicine2013This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
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To the Editor: With reference to the interesting paper by Kaul et al,1 tuberculosis (TB) is one of the important non-parasitic causes of chyluria. TB is a common health threat in India with a prevalence of 545 per 100 000 and ranged from 201 in the highest quintile to 1100 in the lowest quintile.2 Kaul et al1 stated in their study that urine test for acidfast bacilli (AFB) in all the studied patents was negative. However, they did not address the applied laboratory test(s) to fill that objective. This is critical as there is a substantial variation in the detection rate of AFB depending on the applied laboratory test. For instance, the detection rate of AFB in urine specimen in patients with suspected renal TB by bacterioscopy (56.25%) is less than that detected by polymerase chain reaction (PCR) method (81.25%).3 Also, the detection of M tuberculosis DNA in renal biopsy tissue by real-time PCR is proved to be highly sensitive as it can increase diagnostic accuracy and provide valuable information regarding the early diagnosis of renal TB.4 Therefore, the over-reliance by Kaul et al1 on negative urine test for AFB to totally exclude TB in all their studied patients with chyluria is questionable.
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REFERENCES
1 Kaul A  Bhadhuria D  Bhat S  Sharma RK  Karoli R  Gupta A    Chyluria: a mimicker of nephrotic syndrome Ann Saudi Med 2012 32 593 5 23396022 
2 Oxlade O  Murray M   Tuberculosis and poverty: why are the poor at greater risk in India? PLoS One 2012 7 e47533 23185241 
3 Dochviri TZ  Katsitadze VA  Khosiashvili GZ  Chigogidze TG   Detection of mycobacteria tuberculosis in patients with urogenital tuberculosis by PCR method Georgian Med News 2005 119 14 7 
4 Sun L  Yuan Q  Feng JM  Yang CM  Yao L  Fan QL    Rapid diagnosis in early stage renal tuberculosis by real-time polymerase chain reaction on renal biopsy specimens Int J Tuberc Lung Dis 2010 14 341 6 20132626