Hyperuricemia drug induced

On the other hand, some diseases are associated with a very high incidence of drug-induced reactions. This seems to be the case for systemic lupus erythematosus (SLE) (Brown and Kanwar 1967) although penicillin allergy does not seem to be more frequent in such patients (Von Maur et al. 1975). Individuals with hyperuricemia on allopurinol treatment, infectious mononucleosis, or lymphatic leukemia... 

Diuretic drugs often cause a mild reduction of the plasma potassium concentration hyponatremia may be observed. Hypercalcemia may occur with hemoconcentration, but occasionally the free-ionized and the protein-bound fraction is increased. Thiazides cause hyperglycemia and reduce glucose tolerance, especially in diabetics. Thiazides may cause prerenal azotemia with hyperuricemia as a result of decreased renal blood flow and GFR as a result of reduced blood volume. Thiazides, like other diuretics, by causing hemoconcentration increase the plasma concentration of lipids. Many thiazides induce microsomal enzymes and thus affect lipoprotein concentrations. 

TABLE 91—2. Drugs Capable of Inducing Hyperuricemia and Gout... 

Pyrazinamide is an antituberculosus drug which may induce hyperuricemia. The active substance, in fact, is pyrazinoic acid, a metabolite of pyrazinamide (Weiner and Tinker, 1972). When a large dose of pyrazinamide (3g) is administered to man, the concentration of pyrazinoic acid in the plasma reaches 10 to 20 mg/liter (Prasad et al., 1977), and the urinary excretion of urate falls to 20% of its control value, the fractional excretion of urate (FEurate) to 2-3% (Steele, 1978). The PZA suppressible excretion of urate represents only a fraction of the total secretion because it does not comprise the part of secreted urate which is reabsorbed. Only if the secretory transport were located below... 

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