Erley C M, Hirschberg R R, Hoefer W, Schaefer K
St. Joseph-Krankenhaus I, Medizinische Abteilung II, Berlin.
Klin Wochenschr. 1989 Mar 1;67(5):308-12. doi: 10.1007/BF01892900.
This report is about a 23-year-old man who required hemodialysis in connection with an acute renal failure resulting from uric acid nephropathy without hyperuricemia. After recovering renal function he showed extreme hypouricemia (0.1-0.3 mg/dl) and elevated uric acid clearance (100-300 ml/min). The fractional excretion of uric acid (Cua/Ccr) could be suppressed by oral pyrazinamide and enhanced by probenecid. As no other renal tubular or metabolic abnormalities were detected, it is suggested that a markedly increased renal tubular urate secretion was responsible for the hypouricemia and also for the rare side-effect of an uric acid nephropathy in this patient.
本报告讲述的是一名23岁男性，因尿酸肾病导致急性肾衰竭，虽无高尿酸血症，但仍需进行血液透析。肾功能恢复后，他出现了极低尿酸血症（0.1 - 0.3mg/dl）以及尿酸清除率升高（100 - 300ml/min）的情况。口服吡嗪酰胺可抑制尿酸分数排泄（Cua/Ccr），而丙磺舒则可增强该排泄。由于未检测到其他肾小管或代谢异常情况，提示肾小管尿酸分泌显著增加是导致该患者低尿酸血症的原因，也是此次尿酸肾病罕见副作用的原因。
