Clinical Findings in Hyperuricemia

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Hypouricemia, a disorder of uric acid metabolism, is one of rare diseases. Although, many investigators have stated that the diagnosis of hypouricemia should be given in less than 2.0mg/dl of serum uric acid (Sur), the basic problem in the definition for hypouricemia remains to be clarified. Furthermore, to our knowledge, several conditions in clinical viewpoint to accept as a disease induced by the metabolic disturbance have not been described. In contrast, the mechanism in renal function for uric acid metabolism and secretion have been widely investigated. In the present paper, the definition for a disease and the clinical procedure were investigated in 8 patients with the disturbance of uric acid metabolism. All patients studied showed 0.94 to 3.21 of Sur and markedly high Cur value. The patients were classified into two groups under the condition of pyrazinamide administration; namely,1) deficiency of renal tubular reabsorption showing no inhibitory effect of pyrazinamide on urinary secretion of uric acid and 2) significant inhibition of tubular reabsorption by pyrazinamide, revealing in urinary hypersecretion of uric acid. The same classification as mentioned above was established by inosine-loading test. A patient who showed normal level of Sur for female (2.89 mg/dl) was made a diagnosis of renal reabsorptive defect from the results of pyrazinamide suppression and inosine-loading test. Therefore, it reasonably suggested that a diagnosis of hypouricemia can not be made by a single information of Sur leyel. On the other hand, checking for clinical procedure in 8 patients was performed for 1 to 7 years. From the results of changing pattern in BUN, creatinine andurinary protein levels, all patients with hypouricemia studied in the present paper seemed to have normal renal function. As a clinical finding, recurrent urolithiasis was recognized in 4 out of 8 patients. The incidence of relapse was significantly high in comparison with 22 per cent of relapse in patients with urinary stone in our clinic. Then, suitable prophylactic for the relapse should be evaluated.
Japanese Society of Gout and Nucleic Acid Metabolismの論文

Clinical Findings in Hyperuricemia

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