Hypouricemia associated with hyperoxypurinemia due to altered renal handling - Analysis by probenecid - and pyrazinamide - loading tests
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概要
- 論文の詳細を見る
We previously reported a case of hyperexcretion of uric acid associated with hypoexcretion of oxypurine. Probenecid - and pyrazinamide - loading tests were performed to study renal transport mechanisms for uric acid (UA), xanthine(X) and hypoxanthine (Hx)in this patient. C<SUB>UA</SUB>/C<SUB>cr</SUB> (uric acid creatinine clearance ratio) did not change after probenecid loading (1.0g) in this patient, while the ratio in the normal group showed a 4.0 - fold increase at 120 min. C<SUB>X</SUB>/C<SUB>cr</SUB> and C<SUB>HX</SUB>/C<SUB>cr</SUB> in this patient were half the control values at the basal state. However, two hours after probenecid loading these ratios were increased to the range of the normal group. In the normal group, C<SUB>UA</SUB>/C<SUB>cr</SUB>/C<SUB>cr</SUB> and C<SUB>X</SUB>/C<SUB>cr</SUB> decreased after loading of 3.0g pyrazinamide, and C<SUB>HX</SUB>/C<SUB>cr</SUB> was almost unchanged. In the present case, C<SUB>UA</SUB>/C<SUB>cr</SUB>, C<SUB>X</SUB>/C<SUB>cr</SUB> and C<SUB>HX</SUB>/C<SUB>cr</SUB> were unchanged even after pyrazinamide loading. There was no appreciable response in uric acid excretion but an excessive response in oxypurine excretion to probenecid. Both uric acid and oxypurine showed refractoriness to pyrazinamide. These results suggest that renal handling of uric acid and oxypurine is selectively disturbed in this patient.
- Japanese Society of Gout and Nucleic Acid Metabolismの論文
著者
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山崎 知行
大阪大学医学部保健学科基礎生体情報学講座
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大野 昭
大阪大学医学部第二内科
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河野 典夫
大阪大学医学部保健学科
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垂井 清一郎
大阪大学医学部小児科学教室
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依藤 史郎
大阪大学医学部保健学科
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桑島 正道
大阪大学医学部第二内科
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清川 裕朗
大阪大学医学部第二内科
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川知 雅典
大阪大学医学部第二内科
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山田 祐也
大阪大学医学部第二内科
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清水 孝郎
大阪大学医学部第二内科
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西村 隆通
大阪大学医学部第二内科
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垂井 清一郎
大阪大学医学部中央臨床検査部
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