Filariasis is traditionally diagnosed on finding microfilaria in peripheral blood smear and in cases of occult filariasis by immunological tests. Clinically, it presents with a wide range of symptoms and signs. We present two cases of filariasis presenting with renal symptoms warranting kidney biopsy. Histopathology of both revealed microfilaria in the glomerular capillary loop. First case was a 23-year-old male who presented with complaints of passage of milky urine. Second case was a 36-year-old female patient who presented with complaints of gross hematuria. Urine examination revealed nephrotic range proteinuria in both patients. Subsequently they underwent guided kidney biopsy for the evaluation of nephrotic range protienuria. Histopathology of both revealed microfilaria in the glomerular capillary loop. However, neither of the two cases showed proliferative changes in the glomeruli. To conclude, diagnosis of filariasis on kidney biopsy by identifying microfilaria is very rare. High index of suspicion is required to diagnose filariasis due to its wide range of clinical presentation and laboratory findings.
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