HYPOURICEMIA
✿ Decreased production
✧ liver disease
✧ inherited xanthine oxidase deficiency
✧ xanthine oxidase inhibitors
☼ allopurnol
☼ febuxostat
✿ Increased renal excretion
✧ tubular defect
☼ Fanconi syndrome
☼ familial renal hypouricemia
✧ volume expansion (excessive iv fluids)
✧ drugs
☼ probenecid
☼ benzbromarone
☼ uricase
☼ fibrates
☼ aspirin
☼ tmp/smx
☼ losartan
HYPERURICEMIA
✿ Increased production
✧ abnormal purine metabolism
☼ hprt deficiency
☼ prpp synthetase overactivity
☼ glycogen storage diseases
✧ increased cell turnover
☼ malignancies
☼ tumor lysis syndrome
☼ hemolytic anemia
☼ polycythemia vera
☼ radiation/ chemotherapy
☼ rhabdomyolysis
☼ psoriasis
☼ paget's disease
✧ high-purine diet
✧ alcohol
✿ Decreased renal excretion
✧ renal insufficiency
✧ tubular dysfunction
✧ volume depletion
✧ acidosis
☼ lactic acidosis
☼ ketoacidosis
✧ insulin resistance (obesity)
✧ hypothyroidism
✧ hyperparathyroidism
✧ sarcoidosis
✧ berylliosis
✧ drug/toxin
☼ thiazide
☼ furosemide
☼ pyrazinamide
☼ nicotinic acid
☼ levodopa
☼ cyclosporine
☼ lead
