Hyperuricemia
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220722946
2008-06-21T07:15:30Z
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{{DiseaseDisorder infobox |
Name = Asymptomatic hyperuricemia |
ICD10 = {{ICD10|E|79|0|e|70}} |
ICD9 = {{ICD9|790.6}} |
ICDO = |
Image = Uric acid.png |
Caption = [[Uric acid]] |
OMIM = |
MedlinePlus = |
eMedicineSubj = med |
eMedicineTopic = 1112 |
DiseasesDB = 5375 |
MeshID = D033461 |
}}
'''Hyperuricemia''' ([[American English]]), or '''hyperuricaemia''' ([[British English]]), is the presence of high levels of [[uric acid]] in the blood. The upper end of the normal range is 360 micromol/L (6 mg/dL) for women and 400 micromol/L (6.8 mg/dL) for men. <ref>{{cite journal |author=Chizyński K, Rózycka M |title=Hyperuricemia |language=Polish |journal=Pol. Merkur. Lekarski |volume=19 |issue=113 |pages=693–6 |year=2005 |pmid=16498814 |doi=}}</ref>
==Causes==
Hyperuricemia is caused either by accelerated generation of uric acid through [[purine]] metabolism or by impaired excretion in the [[kidney]], or by high levels of [[fructose]] in the diet.<ref>{{cite journal |author=Nakagawa T, Hu H, Zharikov S, ''et al'' |title=A causal role for uric acid in fructose-induced metabolic syndrome |journal=Am. J. Physiol. Renal Physiol. |volume=290 |issue=3 |pages=F625–31 |year=2006 |pmid=16234313 |doi=10.1152/ajprenal.00140.2005}}</ref><ref>{{cite journal |author=Mayes PA |title=Intermediary metabolism of fructose |journal=Am. J. Clin. Nutr. |volume=58 |issue=5 Suppl |pages=754S–765S |year=1993 |pmid=8213607 |doi=}}</ref>. A common fructose found in processed food is [[high-fructose corn syrup]] (HFCS), which is the dominant ingredient in soft drinks, candy, fruit preserves, jam, and jelly <ref name=sugarfix>{{cite book |last=Johnson |first=Richard Joseph |coauthors=Timothy Gower |title=The Sugar Fix : The High-Fructose Fallout That is Making You Fat and Sick |publisher=[http://www.rodale.com/ Rodale] |date=2008 |location=US |pages=304| isbn=13 978-1-59486-665-4 |isbn=10 1-59486-665-1}}</ref>.
Consumption of purine-rich diets is one of the main causes of hyperuricemia. Other dietary causes are ingestion of high protein and fat, and starvation. Starvation results in the body metabolizing its own muscle mass for energy, in the process releasing purines into the bloodstream. Purine bases composition of foods varies. Foods with higher content of purine bases adenine and hypoxanthine are suggested to be more potent in exacerbating hyperuricemia.<ref>{{cite journal |author=Brule, D. Sarwar, G. and Savoie |title=Changes in Serum Uric Acid Levels in Normal Human Subjects Fed Purine-Rich Foods Containing Different Amounts of Adenine and Hypoxanthine |journal=Journal of American College of Nutrition |volume=11 |issue=3 |pages=353–358 |year=1992}}</ref>
Humans lack [[urate oxidase]], an [[enzyme]] which degrades uric acid. Increased levels predispose for [[gout]] and (if very high) [[renal failure]]. Apart from normal variation (with a genetic component), [[tumor lysis syndrome]] produces extreme levels of uric acid, mainly leading to renal failure. The [[Lesch-Nyhan syndrome]] is also associated with extremely high levels of uric acid. The [[Metabolic syndrome]] often presents with hyperuricemia, while a hyperuricemic syndrome is also common in [[Dalmatian (dog)|Dalmatian dogs]].
==Treatment==
*[[Aquaretics]]
*[[Allopurinol]] (200-300mg by mouth once daily) use is controversial. By reducing uric acid production in the body, uric acid stores in the body could be mobilized leading to [[nephrolithiasis]] or [[gout]].{{Fact|date=August 2007}}
*[[Alkalinity|Alkalinizing]] the urine with [[sodium bicarbonate]], Stohl's Solution, or [[Acetazolamide]].
*Low [[purine]] diet (see [[gout]]).
*[[Febuxostat]] has been investigated.<ref>{{cite journal |author=Becker MA, Schumacher HR, Wortmann RL, ''et al'' |title=Febuxostat compared with allopurinol in patients with hyperuricemia and gout |journal=N. Engl. J. Med. |volume=353 |issue=23 |pages=2450–61 |year=2005 |pmid=16339094 |doi=10.1056/NEJMoa050373}}</ref>
*[[Benemid]] (Probenecid) is an uricosuric that promotes uric acid excretion in the kidneys, lowering uric acid levels in blood. Following LeChatelier's principle, if the patient has suffered from chronic gout episodes, uric acid crystals in joints will be mobilized and will dissolve into blood as uric acid levels in blood keep decreasing while it is being excreted through the kidneys.
==See also==
* [[Hypouricemia]]
* [[Fructose]]
==External links==
* {{FPnotebook|REN87}}
*[http://www.dietaryfiberfood.com/purine-food.php Purine Content of Food] at dietaryfiberfood.com
==References==
{{Reflist|2}}
{{Purine, pyrimidine, porphyrin, bilirubin metabolic pathology}}
{{Abnormal clinical and laboratory findings}}
[[Category:uric acid]]
{{med-sign-stub}}
[[ca:Hiperuricèmia]]
[[de:Hyperurikämie]]
[[es:Hiperuricemia]]
[[fr:Hyperuricémie]]
[[ja:高尿酸血症]]
[[pl:Hiperurykemia]]
[[pt:Hiperuricemia]]
[[ru:Гиперурицемия]]