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Causes of Hyperuricemia and Hypouricemia

Hyperuricemia

The causes of hyperuricemia may be primary or secondary.

Primary

Overproduction:

  • Idiopathic
  • Lesch-Nyhan syndrome
  • Glucose-6-phosphatase deficiency

Reduced excretion:

  • Idiopathic
Secondary

Overproduction     

  • Myeloproliferative disease
  • Lymphoma, leukaemia
  • Multiple myeloma
  • Cytotoxic therapy
  • Other malignancies
  • Psoriasis
  • Alcohol
  • Dietary

Reduced excretion

  • Renal failure
  • Drugs-diuretics, aspirin
  • Lactic acidaemia – alcohol, exercise
  • Ketoacidaemia-alcohol, diabetes, starvation
  • Pregnancy-induced hypertension
Hypouricemia

Decreased production

  • Xanthine oxidase deficiency
  • Allopurinol therapy

Increased excretion

  • Fanconi syndrome
  • Uricosuric drugs (including high-dose salicylates)
  • SIADH
  • Isolated tubular defect
  • Early pregnancy

 

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