Wednesday, April 3, 2013

Acidum uricum


Introduction

Hyperuricemia is caused by increased production of uric acid, decreased excretion of uric acid, or by both of these causes.
Hyperuricemia may be primary or secondary.
Primary hyperuricemia if there is no condition that causes an increased production or decreased excretion of uric acid
Secondary hyperuricemia if there is excessive production of uric acid, decreased excretion of uric acid, or both, can be attributed to a known state.



Normal values:
women, MGH 2.3 to 6.6 mg / dL; SI 137-393 mmol / L;
MGH males from 3.6 to 8.5 mg / dL; SI 214-506 mmol / L)

The causes of elevated
Secondary causes of hyperuricemia caused by excessive uric acid creation:

    Gout (gout)
    Acidosis (acidosis)
    Addison's disease
    Nephrogenic diabetes insipidus (nephrogenic diabetes insipidus)
    Polycystic kidney disease (polycystic kidneys)
    Hereditary-hereditary enzyme deficiency: hypoxanthine-guanine-transferase fosforibosil myeloproliferative disorders (myeloproliferative disorders)
    Lymphoproliferative disease
    Tissue hypoxia
    Obesity / thickness
    Malignity
    Active psoriasis (psoriasis active)
    Hemolytic disorders - excessive cell lysis-decay: hemoterapeutski preparations, radio therapy, leukemia, lymphoma, hemolytic anemia
    Diet rich in purines or protein (diet high in purines or protein)
    Alcohol
    Vitamin B12
    Nicotinic acid
    Drugs (cytotoxic drugs, warfarin)

Secondary causes of hyperuricemia due to decreased excretion of uric acid:

    Chronic renal failure
    Lead nephropathy (lead poisoning)
    Obesity / thickness
    The lack of fluid volume
    Lactic acidosis
    Ketoacidosis (diabetic, due to starvation)
    Hypothyroidism (hypothyroidism)
    Hyperparathyroidism
    Sarcoidosis
    Drugs (thiazide diuretics, loop diuretics, renal, low-dose aspirin, ethambutol, pyrazinamide, cyclosporine, levedopa, metoksifluram, abuse of laxatives)
    Alcohol

The causes of reduced values:

    Drugs: allopurinol, high doses of aspirin, probenecid, warfarin, corticosteroids
    Lack of xanthine oxidase (xanthine oxidase deficiency of)
    Syndrome of inappropriate secretion of antidiuretic hormone (SIADH)
    Trou-Fanconi syndrome (renal tubular deficits: Fanconi's syndrome)
    Alcoholism (alcoholism)
    Liver disease (liver disease)
    Diets deficient in protein or purines (diet deficient in protein or purines)
    Wilson's disease (Wilson's disease)
    Hemochromatosis (hemochromatosis)

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