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20-September-2008 09:55:48 - Hyperuricemia Asymptomatic hyperuricemia Classification and external resources Uric acid ICD-10 E79.0 ICD-9 790.6 DiseasesDB 5375 eMedicine med/1112 MeSH D033461 Hyperuricemia American English, or hyperuricaemia British English, is the presence of high levels of uric acid in the blood. The upper end of the normal range is 360 micromol/L 6 mg/dL for women and 400 micromol/L 6.8 mg/dL for men. 1 Contents 1 Causes 2 Treatment 3 See also 4 External links 5 References Causes Hyperuricemia is caused either by accelerated generation of uric acid through purine metabolism or by impaired excretion in the kidney, or by high levels of fructose in the diet.23. A common fructose found in processed food is high-fructose corn syrup HFCS, which is the dominant ingredient in soft drinks, candy, fruit preserves, jam, and jelly 4. Consumption of purine-rich diets is one of the main causes of hyperuricemia. Other dietary causes are ingestion of high protein and fat citation needed, and starvation. Starvation results in the body metabolizing its own muscle mass for energy, in the process releasing purines into the bloodstream. Purine bases composition of foods varies. Foods with higher content of purine bases adenine and hypoxanthine are suggested to be more potent in exacerbating hyperuricemia.5 Humans lack urate oxidase, an enzyme which degrades uric acid. Increased levels predispose for gout and if very high renal failure. Apart from normal variation with a genetic component, tumor lysis syndrome produces extreme levels of uric acid, mainly leading to renal failure. The Lesch-Nyhan syndrome is also associated with extremely high levels of uric acid. The Metabolic syndrome often presents with hyperuricemia, while a hyperuricemic syndrome is also common in Dalmatian dogs. Treatment Aquaretics Allopurinol 200-300mg by mouth once daily use is controversial. By reducing uric acid production in the body, uric acid stores in the body could be mobilized leading to nephrolithiasis or gout.citation needed Alkalinizing the urine with sodium bicarbonate, Stohl's Solution, or Acetazolamide. Low purine diet see gout. Febuxostat has been investigated.6 Benemid Probenecid is an uricosuric that promotes uric acid excretion in the kidneys, lowering uric acid levels in blood. Following LeChatelier's principle, if the patient has suffered from chronic gout episodes, uric acid crystals in joints will be mobilized and will dissolve into blood as uric acid levels in blood keep decreasing while it is being excreted through the kidneys. See also Hypouricemia Fructose External links Purine Content of Food at dietaryfiberfood.com References ^ ChizyÅ„ski K, Rózycka M 2005. Hyperuricemia in Polish. Pol. Merkur. Lekarski 19 113: 693-6. PMID 16498814. ^ Nakagawa T, Hu H, Zharikov S, et al 2006. A causal role for uric acid in fructose-induced metabolic syndrome. Am. J. Physiol. Renal Physiol. 290 3: F625-31. doi:10.1152/ajprenal.00140.2005. PMID 16234313. ^ Mayes PA 1993. Intermediary metabolism of fructose. Am. J. Clin. Nutr. 58 5 Suppl: 754S-765S. PMID 8213607. ^ Johnson, Richard Joseph; Timothy Gower 2008. The Sugar Fix : The High-Fructose Fallout That is Making You Fat and Sick. US: Rodale, 304. ISBN 10 1-59486-665-1. ^ Brule, D. Sarwar, G. and Savoie 1992. Changes in Serum Uric Acid Levels in Normal Human Subjects Fed Purine-Rich Foods Containing Different Amounts of Adenine and Hypoxanthine. Journal of American College of Nutrition 11 3: 353-358. ^ Becker MA, Schumacher HR, Wortmann RL, et al 2005. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N. Engl. J. Med. 353 23: 2450-61. doi:10.1056/NEJMoa050373. PMID 16339094. v d e Inborn errors of purine-pyrimidine metabolism E79, 277.2 Purine metabolism Anabolism Adenylosuccinate lyase deficiency Nucleotide salvage Lesch-Nyhan syndrome/Hyperuricemia - Adenine phosphoribosyltransferase deficiency Catabolism Adenosine deaminase deficiency - Purine nucleoside phosphorylase deficiency - Xanthinuria - Gout Pyrimidine metabolism Anabolism Orotic aciduria Catabolism Dihydropyrimidine dehydrogenase deficiency see also nucleotide metabolism, intermediates v d e Abnormal clinical and laboratory findings R70-R94, 790-796 Blood test Red blood cells Elevated ESR - Anisocytosis - Poikilocytosis - Reticulocytosis - Inclusion bodies Howell-Jolly body, Heinz body Small molecules blood sugar: Abnormal glucose tolerance test - Hyperglycemia - Impaired glucose tolerance - Prediabetes other small molecules: Azotemia - Hyperuricemia Enzymes/other proteins Elevated transaminases - Cardiac marker - Elevated alpha-fetoprotein Minerals Iron overload disorder Pathogens/sepsis Bacteremia - Viremia - Fungemia - Parasitemia Urine test Proteinuria Albuminuria/Microalbuminuria - Myoglobinuria - Hemoglobinuria Small molecules Glycosuria - Ketonuria - Bilirubinuria Red blood cells Hematuria Other Chyluria - Crystalluria Other Abnormal basal metabolic rate - Latent tuberculosis This medical sign article is a stub. Retrieved from http://en..org/wiki/Hyperuricemia Categories: Metabolic disorders | Uric acid | Medical sign stubsHidden categories: All articles with statements | Articles with statements since August 2007 Views Article Discussion this page History Personal tools Log in / create account Navigation Main page Contents Featured content Current events Random article Search Go Search Interaction Community portal Recent changes Contact Donate to Help Toolbox What links here Related changes Upload file Special pages Printable version Permanent link Cite this page Languages Català Deutsch Español Français 日本語 Polski Português РуÑ?Ñ?кий This page was last modified on 14 August 2008, at 12:48
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