Impaired uric acid excretion |
Idiopathic (primary) |
Chronic renal disease |
Increased tubular reabsorption (extracellular volume contraction) Dehydration, diuretics, diabetes insipidus |
Decreased tubular secretion Starvation, diabetic ketoacidosis |
Increased lactic acid production Alcohol, exercise, toxemia of pregnancy |
Drug treatment Low-dose aspirin, ciclosporin, diuretics (especially thiazides and loop diuretics) |
Hypothyroidism |
Primary hyperparathyroidism |
Glucose-6-phosphatase deficiency (von Gierke’s disease) |
Increased uric acid production |
Idiopathic (primary) |
Increased nucleic acid turnover Blood dyscrasias, e.g. leukemia, polycythaemia rubra vera Malignancies Severe psoriasis |
Excessive purine intake |
Increased purine synthesis (rare) HGPRT deficiency (Lesch–Nyhan) PRPP overactivity Glucose-6-phosphatase deficiency |
Impaired uric acid excretion |
Idiopathic (primary) |
Chronic renal disease |
Increased tubular reabsorption (extracellular volume contraction) Dehydration, diuretics, diabetes insipidus |
Decreased tubular secretion Starvation, diabetic ketoacidosis |
Increased lactic acid production Alcohol, exercise, toxemia of pregnancy |
Drug treatment Low-dose aspirin, ciclosporin, diuretics (especially thiazides and loop diuretics) |
Hypothyroidism |
Primary hyperparathyroidism |
Glucose-6-phosphatase deficiency (von Gierke’s disease) |
Increased uric acid production |
Idiopathic (primary) |
Increased nucleic acid turnover Blood dyscrasias, e.g. leukemia, polycythaemia rubra vera Malignancies Severe psoriasis |
Excessive purine intake |
Increased purine synthesis (rare) HGPRT deficiency (Lesch–Nyhan) PRPP overactivity Glucose-6-phosphatase deficiency |
HGPRT, hypoxanthine-guanine phosphoribosyltransferase; PRPP, phosphoribosylpyrophosphate synthetase
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