Smetana S S, Bar-Khayim Y
Arch Intern Med. 1985 Jul;145(7):1200-3.
Hypouricemia with hyperuricosuria due to isolated renal tubular defects are rare conditions. Two patients with hypouricemia and hyperuricosuria were studied for derangements in the renal urate transport with the combined probenecid-pyrazinamide test. In the first patient a significant decrease (64.5%) in the urate clearance--creatinine clearance ratio was noted after pyrazinamide administration, suggesting a post-secretory urate reabsorption defect, whereas the significant rise (44.2%) in urate clearance after the administration of probenecid indicates that this defect may not be complete. In the second patient there was a rise of 96.9% in the urate clearance--creatinine clearance ratio after the administration of probenecid and a decline of 31.6% in that ratio after pyrazinamide. These results suggest a defect in the presecretory reabsorptive site, with a highly significant response most probably of the postsecretory reabsorptive site to probenecid.
由于孤立性肾小管缺陷导致的低尿酸血症伴高尿酸尿症是罕见的情况。对两名低尿酸血症和高尿酸尿症患者进行了丙磺舒 - 吡嗪酰胺联合试验，以研究肾脏尿酸转运的紊乱情况。在第一名患者中，服用吡嗪酰胺后尿酸清除率与肌酐清除率之比显著降低（64.5%），提示分泌后尿酸重吸收缺陷，而服用丙磺舒后尿酸清除率显著升高（44.2%），表明该缺陷可能不完全。在第二名患者中，服用丙磺舒后尿酸清除率与肌酐清除率之比升高了96.9%，服用吡嗪酰胺后该比值下降了31.6%。这些结果提示分泌前重吸收部位存在缺陷，分泌后重吸收部位对丙磺舒的反应很可能非常显著。
