Hypouricaemia With Acute Viral Hepatitis

Hisatome, Ichiro; Kotake, Hiroshi; Oginö, Kazuhíde; Ishiko, Riichiro; Hasegawa, Junichi; Mashiba, Hiroto; Satō, Ryōichi; Okumura, Hidemasa

doi:10.1093/rheumatology/28.6.525

Cited by 6 publications

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“…Such conditions result in a rise in the clearance of uric acid. An elevated serum bilirubin level may also cause a selective tubulopathy for uric acid 33 . Second, uric acid synthesis is decreased in liver disease.…”

Section: Discussionmentioning

confidence: 99%

“…Second, uric acid synthesis is decreased in liver disease. Hepatic cell derangement such as reduced xanthine oxidase activity may result in decreased de novo urate synthesis 33 . Semistarvation induced by anorexia may also result in the lowering of urate 33 …”

Section: Discussionmentioning

confidence: 99%

“…31,32 Hypouricaemia has been found in liver diseases, most commonly cirrhosis, metastatic liver cancer, fulminant hepatitis and primary biliary cirrhosis. 33 The possible mechanisms of hypouricaemia in liver disease are as follows. First, uric acid clearance is increased.…”

Section: Discussionmentioning

confidence: 99%

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Prevalence of hypouricaemia and SLC22A12 mutations in healthy Korean subjects

et al. 2008

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Prevalence of hypouricaemia and SLC22A12 mutations in healthy Korean subjects

et al. 2008

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“…[1][2][3][4][5][6] However, no detailed evaluation of the underlying tubular abnormalities leading to the hypouricemia has been undertaken yet. In the present study, we examined the renal tubular function in patients with obstructive jaundice of various severity and causes to explore whether the urate wasting, commonly encountered in such cases, is an isolated lesion or part of a generalized proximal tubular defect.…”

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confidence: 99%

Partially Reversible Renal Tubular Damage in Patients With Obstructive Jaundice

et al. 2001

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Decreased serum uric acid levels resulting from renal urate wasting have been occasionally encountered in jaundiced patients. However, in these cases, there are no data concerning the underlying renal tubular defects. In the present study, we investigated the renal tubular function in 35 patients with obstructive jaundice of various severity and causes (11 with lithiasis, 17 with carcinoma, and 7 with intrahepatic cholestasis). A detailed study of the renal tubular function was performed. Beyond the conventional methods, 1 H-NMR spectroscopy of urine was used to evaluate noninvasively renal damage by the characteristic perturbation in the excretion pattern of low-molecular weight endogenous metabolites. On admission, patients with obstructive jaundice had significantly lower serum uric acid and phosphate levels and higher bile acid concentrations compared with 40 age-and sex-matched controls. Serum uric acid levels presented a negative correlation with the total and direct bilirubin as well as the fractional excretion of uric acid. Furthermore, a great number of the patients studied developed one or more proximal tubular dysfunction manifestations beyond uricosuria, such as renal glucosuria, phosphaturia, and increased excretion of ␣ 1 -microglobulin. 1 H-NMR spectroscopy of the urine showed decreased levels of citrate and hippurate and increased levels of 3-hydroxybutyrate and acetate. In 12 patients partial or complete remission of jaundice was followed by an improvement of the proximal renal tubular damage. In conclusion, obstructive jaundice can cause a partially reversible generalized proximal tubular dysfunction. (HEPATOLOGY 2001;33:1365-1369.)It has been occasionally reported that jaundiced patients, particularly those suffering from cancer, develop decreased serum uric acid levels resulting from inappropriate uricosuria. 1-6 However, no detailed evaluation of the underlying tubular abnormalities leading to the hypouricemia has been undertaken yet. In the present study, we examined the renal tubular function in patients with obstructive jaundice of various severity and causes to explore whether the urate wasting, commonly encountered in such cases, is an isolated lesion or part of a generalized proximal tubular defect. Beyond the conventional methods, we used 1 H-NMR spectroscopy to evaluate noninvasively the underlying renal damage by the characteristic perturbation in the excretion pattern of low molecular weight endogenous metabolites. In fact, urinalysis by NMR spectroscopy has led to the detailed investigation of the excretion pattern in various physiological and pathological situations and allowed the detection of unexpected constituents related to disease or tissue damage. 7-9 PATIENTS AND METHODSWe studied 35 patients with obstructive jaundice (21 male, 14 female, mean age 40 Ϯ 11 years) during their hospitalization. The patients had jaundice with predominantly conjugated bilirubinemia in combination with prominent elevations of the alkaline phosphatase, 5-nucleotidase, and gamma-glutamyltranspept...

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“…The former cases were xanthinuria [12], hereditary deficiency of purine nucleoside phosphorylase [13], liver disease [14], administra tion of allopurinol, and the latter cases were Wilson's dis ease [15], Fanconi syndrome [16], neoplastic disease [17], diabetes mellitus [7], administration of uricosuric drugs, and renal hypouricemia with isolated tubular defect of urate transport [3].…”

Section: Effect O F Inosine On Urate Excretionmentioning

confidence: 99%

Renal Hypouricemia with Both Drug-Insensitive Secretion and Defective Reabsorption of Urate: A Novel Type of Renal Hypouricemia

Hisatome

Kato

Miyakoda

et al. 1993

Nephron

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Renal handling of urate in the hypouricemic patient with increase in both urate clearance (Cur) and Cur/creatinine clearance (Ccr) and normal urinary excretion of urate was studied according to the pharmacological evaluation. In the present case there was no response of urate excretion to either pyrazinamide or probenecid. Both furosemide and prednisolone could not alter Cur and Cur/ Ccr. Administration of inosine could have increased Cur, which was greater than Ccr. These results suggest that the present case had the defect of both pre- and postsecretory reabsorption of urate, accompanied by the existence of drug-insensitive secretion of urate, which is different from hitherto known types of renal hypouricemia, i.e. a novel type of renal hypouricemia.

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Hypouricaemia With Acute Viral Hepatitis

Cited by 6 publications

References 0 publications

Prevalence of hypouricaemia and SLC22A12 mutations in healthy Korean subjects

Prevalence of hypouricaemia and SLC22A12 mutations in healthy Korean subjects

Partially Reversible Renal Tubular Damage in Patients With Obstructive Jaundice

Renal Hypouricemia with Both Drug-Insensitive Secretion and Defective Reabsorption of Urate: A Novel Type of Renal Hypouricemia

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