|
HYPERURICAEMIA / GOUT |
|
1� gout (90%) [occurs in men and post-menopausal females] |
||
|
unknown enzyme defects (85-90% of 1� gout): |
over-production of uric acid with either normal excretion (majority) or increased excretion (minority)normal production of uric acid with decreased excretion |
|
|
known enzyme defects: |
partial HGPRT deficiency [rare; causes increased production of uric acid] |
|
|
2� gout (10%) |
||||
|
increased nucleic acid turnover: |
leukaemias severe exfoliative psoriasis Hodgkin's disease polycythaemia rubra vera haemolytic anaemias |
myeloproliferative disorders multiple myeloma high purine diet chemotherapy of myeloproliferative and lymphoproliferative disorders |
||
|
decreased renal excretion of uric acid: |
drugs: |
diuretics ethambutol low dose aspirin pyrazinamide alcohol |
||
|
endocrine disorders: |
hyperparathyroidism myxoedema |
|||
|
other: |
chronic renal disease lead poisoning pregnancy-induced hypertension Down's syndrome starvation, exercise G6PD deficiency hyperlipidaemia lactic acidosis |
|||
|
inborn errors of metabolism: |
type I glycogen storage disease complete HGPRT deficiency in Lesch-Nyhan syndrome PRPP synthase over activity |
|||
click here to return to the main contents page of Differential Diagnoses in General Medicine