Investigation of serum uric acid levels in pediatric patients with acute leukemia at different stages of treatment
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概要
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The purpose of the current study is to evaluate the changes of serum uric acid levels (sUA) in pediatric patients mainly with acute lymphoblastic leukemia (ALL) at different stages of treatment. Based on the reference values of sUA in children established by M. Kubota in 2009, we calculated sUA z-scores for each patient. Z-scores of more than +2.0 and less than -2.0 were considered to indicate hyperuricemia and hypouricemia, respectively. Before starting chemotherapy, 23 out of 67 patients (34.3%) had hyperuricemia and the prevalence was significantly higher in males. When multiple logistic analysis using several variables, including sex, age, white blood cell counts, creatinine, BUN, LDH, CRP and albumin, was performed, white blood cell counts, creatinine and LDH were significantly associated with sUA z-scores. During chemotherapy, 10 out of 23 patients (43.5%) experienced hypouricemia, whereas only 1 patient (4.3%) experienced hyperuricemia. Hypouricemia was commonly seen at the post-consolidation and post-reconsolidation phases. During the follow-up after completion of treatment in 38 patients with ALL, acute myelogenous leukemia and chronic myelogenous leukemia, 4 (10.5%) and 1 (2.6%) patients had hyperuricemia and hypouricemia, respectively. Although the association was not statistically significant, the patients tended to have a greater number of factors related to metabolic syndrome (abdominal obesity, hypertension, hyperglycemia and dyslipidemia) as their sUA z-scores increased. Although the study cohort at each stage of treatment differed, to our knowledge, this is the first comprehensive study focused on the measurement of sUA at different stages of leukemia treatment. These results may be useful for managing sUA in pediatric patients with leukemia.
- 一般社団法人 日本痛風・核酸代謝学会の論文