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Hypouricaemia with acute viral hepatitis
I Hisatome1, H Kotake, K Ogino
11st Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
British Journal of Rheumatology
|December 1, 1989
Summary
Acute viral hepatitis can cause hypouricemia (low uric acid) in women. This condition may involve increased renal uricosuria and potentially inhibited xanthine oxidase activity, with serum urate levels normalizing after liver function improves.
Area of Science:
- Nephrology
- Hepatology
- Clinical Biochemistry
Background:
- Hypouricemia, characterized by low serum uric acid levels, can be associated with various conditions.
- Acute viral hepatitis is a potential, though less commonly recognized, cause of transient hypouricemia.
Purpose of the Study:
- To investigate the mechanisms underlying hypouricemia in female patients with acute viral hepatitis.
- To compare urate metabolism in these patients with those suffering from inborn renal hypouricemia.
Main Methods:
- Clinical case series of five female patients with hypouricemia and acute viral hepatitis.
- Measurement of serum urate, urate clearance, 24-hour urate excretion, and oxypurine levels.
- Comparison with four cases of inborn renal hypouricemia.
Main Results:
- Patients exhibited low serum urate (101 +/- 12 mumol/l) during hyperbilirubinemia.
- Increased urate clearance (14.2 +/- 3.4 ml/min) was observed, but 24-h urate excretion remained normal.
- Serum urate normalized upon improvement of liver function, suggesting a transient, hepatitis-induced phenomenon.
Conclusions:
- Acute viral hepatitis can lead to hypouricemia, potentially through increased renal uricosuria and possibly via inhibition of xanthine oxidase activity.
- The observed uricosuria was less pronounced than in inborn renal hypouricemia.
- These findings highlight a distinct mechanism of hypouricemia related to liver dysfunction.