Hyperuricemia and Arthralgias During Pyrazinamide Therapy in Patients With Pulmonary Tuberculosis

Qureshi, Waseem; Ghulam, Hassan; Kadri, SM; Khan, Ghulam Qadir; Arshad, Ali

doi:10.1309/7gbyqty62pfehdp1

Cited by 16 publications

(12 citation statements)

References 7 publications

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“…(5,6,10,11) In a small, double-blind, placebo-controlled study of aspirin and allopurinol, a reduction in SUA levels was observed with aspirin, but not with allopurinol. (12) Moreover, in a pharmacokinetic study involving six healthy subjects, allopurinol was shown to increase plasma concentrations of pyrazinoic acid, a chemical that is directly responsible for the inhibition of renal urate secretion.…”

Section: Discussionmentioning

confidence: 99%

Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia

Gerdan¹,

Akkoç²,

Uçan³

et al. 2013

smedj

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We report the case of a 36-year-old man with psoriatic arthritis and miliary tuberculosis, whose serum uric acid (SUA) level increased after the initiation of antituberculosis treatment, which included pyrazinamide. Most strikingly and paradoxically, the patient's SUA level increased after treatment with allopurinol. On cessation of allopurinol, his SUA level decreased substantially, and complete normalisation was observed following the discontinuation of pyrazinamide treatment.

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Section: Discussionmentioning

confidence: 99%

Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia

Gerdan¹,

Akkoç²,

Uçan³

et al. 2013

smedj

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“…Ina study [22], the authors also observed high level of uric acid in pulmonary tuberculosis compared with the control group. Some other report [23] showed a significant increase in uric acid level in TB patients on pyrazinamide therapy. Generally, free radicals attack onmembrane are cytotoxic and cytoclastic and could result in tissue [24] and this may explain in part the increased uric acid levels seenin pulmonaryTB subjects in the present study.…”

Section: Discussionmentioning

confidence: 84%

Evaluation of Albuminand Uric Acid Levels, Catalaseactivity andtotal Antioxidant Statusin Pulmonary Tuberculosis Patientsin Osogbo, Nigeria

Olisekodiaka¹,

Igbeneghu²,

Aj³

et al. 2017

IOSR JDMS

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“…Drug‐induced hyperuricemia is a well‐known adverse effect of several anti‐TB drugs . The incidence of PZA‐induced hyperuricemia has been reported to affect 43.0%–86.3% of patients treated with PZA alone or in combination therapy . The main mechanism of PZA‐induced hyperuricemia is via the anti‐uricosuric effect, causing a >80% reduction in renal clearance of uric acid when administered at a 300 mg therapeutic daily dose .…”

Section: Discussionmentioning

confidence: 99%

“…7 The incidence of PZA-induced hyperuricemia has been reported to affect 43.0%-86.3% of patients treated with PZA alone or in combination therapy. 14,15 The main mechanism of PZA-induced hyperuricemia is via the anti-uricosuric effect, causing a >80% reduction in renal clearance of uric acid when administered at a 300 mg therapeutic daily dose. 16 Pyrazinecarboxylic acid (pyrazinoic acid) is an active metabolite of PZA and is oxidized by xanthine oxidase, which leads to increased urate reabsorption through its trans-stimulatory effect on the urate transporter (URAT1).…”

Section: Discussionmentioning

confidence: 99%

Clinical features and risk factors for gout attacks during anti‐tuberculosis treatment: A case‐control study in South Korea

Chung

Lee

et al. 2019

Int J of Rheum Dis

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Aim This study aimed to investigate the clinical features and risk factors of gout attacks during anti‐tuberculosis (TB) treatment in South Korea. Method We investigated the clinical characteristics of 49 patients who suffered from gout attacks while taking anti‐TB medications. Among them, 25 TB patients having newly developed gout attacks without prior history of gout were set to the gout group. Seventy‐five age‐ and sex‐matched TB patients without gout attacks during anti‐TB therapy were randomly selected as the control group. The demographics, clinical features, and laboratory findings between the two groups were compared to establish risk factors of gout attack during anti‐TB treatment. Results The gout patients had a mean age of 67.7 ± 13.2 years and 39 patients (79.6%) were male. Approximately half of the patients experienced an attack within 2 months of treatment initiation. The attacks typically involved lower extremity joints (87.8%). The serum uric acid (SUA) levels were significantly elevated at 2 and 6 months after starting anti‐TB medication compared with those at baseline. In the case‐control study, the factors associated with gout attack were higher body mass index (BMI), higher pre‐treatment SUA levels, dyslipidemia, and reduced renal function. In the multivariate model, higher BMI, chronic kidney disease (CKD), and pre‐treatment hyperuricemia (SUA ≥ 6.8 mg/dL) were independent risk factors of gout attack while taking anti‐TB medication. Conclusions Patients with high BMI, CKD, and pre‐treatment hyperuricemia are at a higher risk of gout attack during TB treatment.

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Hyperuricemia and Arthralgias During Pyrazinamide Therapy in Patients With Pulmonary Tuberculosis

Cited by 16 publications

References 7 publications

Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia

Paradoxical increase in uric acid level with allopurinol use in pyrazinamide-induced hyperuricaemia

Evaluation of Albuminand Uric Acid Levels, Catalaseactivity andtotal Antioxidant Statusin Pulmonary Tuberculosis Patientsin Osogbo, Nigeria

Clinical features and risk factors for gout attacks during anti‐tuberculosis treatment: A case‐control study in South Korea

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