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Gout and hyperuricemia associated with sickle-cell anemia
Seminars in Arthritis and Rheumatism
|May 1, 1983
Summary
Sickle cell disease (SCA) patients often develop hyperuricemia due to increased nucleic acid breakdown. Renal complications can impair urate excretion, leading to gouty arthritis, particularly in women.
Area of Science:
- Nephrology
- Rheumatology
- Hematology
Background:
- Sickle cell arthritis (SCA) is linked to gouty arthritis, with over 12 reported cases.
- High prevalence of hyperuricemia observed in SCA patients since childhood.
Observation:
- Increased nucleic acid synthesis and subsequent urate generation occur due to erythropoietic response to hemolysis in SCA.
- While initially compensated by increased urinary urate excretion, renal tubule damage from sickling impairs this response by the third decade.
- This impairment leads to sustained hyperuricemia, increasing the risk of gouty arthritis.
Findings:
- The exact prevalence of gout in SCA, considering age and sex, remains undetermined.
- Further research is needed to correlate SCA aspects with hyperuricemia and gout, including the impact of sickle cell crises and renal urate handling abnormalities.
- The potential role of hyperuricemia and hyperuricosuria in SCA's renal manifestations requires investigation.
Implications:
- Understanding these relationships may reveal allopurinol's utility in preventing and treating renal disease in SCA patients.
- Further studies can clarify the interplay between SCA, urate metabolism, and renal function.
- This research can inform targeted interventions for managing gout and renal complications in SCA.