Godin M
Nouv Presse Med. 1979 Dec 24;8(50):4099-103.
Hypouricaemia (blood level blow 2 mg/100 ml or 12 mumol/100 ml) is rarely observed, i.e., in less than 1% of hospitalized patients. Hypouricaemia can be induced by any of three mechanisms: a decrease in uric acid synthesis due to deficient xanthine oxydase (e.g., hereditary xanthinuria, severe liver disease, treatment with allopurinol); increased uricolysis due to drug therapy; increased urinary excretion of uric acid. This increased urinary excretion is due to abnormal uric acid transport in the proximal tubule. It is sometimes observed alone (primary hereditary anomaly of tubular uric acid transport, severe liver disease or neoplasia, drugs, or contrast media). It can also be observed in association with other proximal tubular anomalies, constituting a Fanconi syndrom. Among observations of hypouricaemia, 50% result from drug therapy and approximately 30% are secondary to liver diseases or neoplasia. It has no special clinical consequence. Nevertheless, the observation of hypouricaemia in a patient should indicate the possibility of drug intoxication or an underlying disease, in particular neoplasia. Measurement of uric acid clearance is a simple method of determining the mechanism responsible and of guiding diagnosis.
低尿酸血症（血中尿酸水平低于2mg/100ml或12μmol/100ml）很少见，即在住院患者中不到1%。低尿酸血症可由三种机制中的任何一种引起：由于黄嘌呤氧化酶缺乏导致尿酸合成减少（如遗传性黄嘌呤尿症、严重肝病、使用别嘌醇治疗）；药物治疗导致尿酸分解增加；尿酸经尿液排泄增加。这种经尿液排泄增加是由于近端肾小管中尿酸转运异常所致。有时单独出现（肾小管尿酸转运的原发性遗传性异常、严重肝病或肿瘤、药物或造影剂）。也可与其他近端肾小管异常同时出现，构成范科尼综合征。在低尿酸血症的病例中，50%是由药物治疗引起的，约30%继发于肝病或肿瘤。它没有特殊的临床后果。然而，在患者中发现低尿酸血症应提示药物中毒或潜在疾病的可能性，尤其是肿瘤。测定尿酸清除率是确定病因机制和指导诊断的一种简单方法。
