Numabe A, Tsukada H, Sugimoto T, Ono H, Hirao S, Abe M, Yagi S
Department of Medicine, Dokkyo University School of Medicine, Tochigi, Japan.
Nihon Jinzo Gakkai Shi. 1992 Jul;34(7):841-5.
This report is a 17-year-old man with an acute renal failure who complained of nausea, vomiting, bilateral loin pain and abdominal pain after scuffle. Renal biopsy specimen obtained from the left kidney revealed acute tubular necrosis. After recovering renal function he showed extreme hypouricemia (serum uric acid, 0.6 mg/dl) and elevated uric acid clearance (62-78 ml/min). The fractional excretion of uric acid (CUA/Ccr) could not be influenced by either oral pyrazinamide or probenecid. As no other renal tubular or metabolic abnormalities were detected, it is suggested that presecretory reabsorption defect or subtotal defect in uric acid transportation was responsible for the hypouricemia in this patient.
本报告介绍了一名17岁男性急性肾衰竭患者，该患者在扭打后出现恶心、呕吐、双侧腰痛和腹痛。从左肾获取的肾活检标本显示急性肾小管坏死。肾功能恢复后，他出现了极低尿酸血症（血清尿酸0.6mg/dl）和尿酸清除率升高（62 - 78ml/min）。口服吡嗪酰胺或丙磺舒均不能影响尿酸排泄分数（CUA/Ccr）。由于未检测到其他肾小管或代谢异常，提示该患者的低尿酸血症是由尿酸分泌前重吸收缺陷或尿酸转运部分缺陷所致。
