Department of Nephrology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Department of Nephrology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Nefrologia (Engl Ed). 2022 May-Jun;42(3):347-350. doi: 10.1016/j.nefroe.2022.07.004.
Hypouricemia may be caused by disorders leading to decreased UA production, oxidation of UA to allantoin by drugs or increased renal tubular loss of filtered UA, renal hypouricemia (RHUC). RHUC may be resulted from familial or acquired disorders. Familial RHUC cases are classified according to the gene affected as type 1 (SLC22A12 gene) and type 2 (SLC2A9). Clinical importance of RHUC entity is mainly determined by emerging of acute kidney injury (AKI) after strenuous exercise and urolithiasis.
Here, we report a case of RHUC with increased fractional excretion of uric acid value of more than 100%, serum uric acid level of nearly zero, and exercise-induced AKI episodes clinically and a new unpublished homozygous (biallelic) mutation of c.1419+2T>G (IVS11+2T>G) in the SLC2A9 gene genetically for the first time to our knowledge.
Clinicians should be aware of this rare entity defined as hereditary RHUC in order to provide long term renoprotection by advisements like simple precautions such as avoiding severe exercises.
低尿酸血症可能由导致 UA 生成减少的疾病引起,也可能由药物将 UA 氧化为尿囊素或肾脏对滤过的 UA 的肾小管丢失增加引起,即肾性低尿酸血症(RHUC)。RHUC 可能由家族性或获得性疾病引起。家族性 RHUC 病例根据受影响的基因分为 1 型(SLC22A12 基因)和 2 型(SLC2A9)。RHUC 实体的临床重要性主要取决于剧烈运动后和尿路结石后急性肾损伤(AKI)的发生。
本案例报告了首例以高尿酸排泄分数值超过 100%、血尿酸水平接近零、运动诱发 AKI 为特征的 RHUC 病例,以及首次在基因上发现 SLC2A9 基因 c.1419+2T>G(IVS11+2T>G)纯合(双等位基因)突变。
临床医生应了解这种罕见的遗传性 RHUC 实体,以便通过简单的预防措施(如避免剧烈运动)提供长期的肾脏保护。