Izumi N, Sakai H, Shinohara S, Daiguji Y, Hasumura Y, Takeuchi J
Gastroenterol Jpn. 1985 Aug;20(4):374-9. doi: 10.1007/BF02774749.
A 51-year-old woman with primary biliary cirrhosis developed distal renal tubular acidosis and hypouricemia (1.4 mg per 100 ml) in the course of hepatic injury. Her renal clearance of uric acid reached 33.7 ml/min (mean +/- SD in five normal age-matched women: 9.2 +/- 3.1 ml/min). Pyrazinamide, an inhibitor of uric acid secretion, considerably reduced the uric acid clearance, while it was not enhanced by probenecid, a blocker of uric acid reabsorption. Thus, the hypouricemia may have been due to a defect of postsecretory reabsorption of uric acid in the renal tubules. The present case emphasizes the significance of hypouricemia and hyperuricosuria as indicators of renal tubular injury in primary biliary cirrhosis.
一名51岁的原发性胆汁性肝硬化女性在肝损伤过程中出现了远端肾小管酸中毒和低尿酸血症（每100毫升1.4毫克）。她的尿酸肾清除率达到33.7毫升/分钟（5名年龄匹配的正常女性的平均值±标准差：9.2±3.1毫升/分钟）。尿酸分泌抑制剂吡嗪酰胺显著降低了尿酸清除率，而尿酸重吸收阻滞剂丙磺舒并未使其增加。因此，低尿酸血症可能是由于肾小管尿酸分泌后重吸收缺陷所致。本病例强调了低尿酸血症和高尿酸尿症作为原发性胆汁性肝硬化肾小管损伤指标的重要性。
