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