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Hyperuricemia in Congenital Heart Disease

Hyperuricemia in Congenital Heart Disease Abstract β Gout is rarely noted as a clinical problem in secondary polycythemia—even if profound polycythemia exists, as in cyanotic congenital heart disease. A retrospective study of 81 patients with congenital heart disease was done to assess the incidence of hyperuricemia. Twenty of 46 patients with cyanotic congenital heart disease had serum levels of uric acid greater than 8 mg/dl. Thirteen of 16 (81%) cyanotic male patients more than 15 years old had serum levels greater than 8 mg/dl. For cyanotic patients, serum levels of uric acid were related directly to the degree of polycythemia (r =.44; P <.02). Impaired renal function or drug therapy did not seem to account for the hyperuricemia. Because levels of uric acid greater than 10 mg/dl probably are nephropathic, many of these patients may be incurring subclinical uric acid nephropathy. (Am J Dis Child 132:900-902, 1978) References 1. Wyngaarden JB: The etiology and pathogenesis of gout , in Hollander JL, McCarty DJ Jr (eds): Arthritis and Allied Conditions: A Textbook of Rheumatology , ed 8. Philadelphia, Lea & Febiger Inc, 1972, p 1095. 2. Somerville J: Gout in cyanotic congenital heart disease . Br Heart J 23:31-34, 1961.Crossref 3. Yü TF, Weissman B, Sharney L, et al: On the biosynthesis of uric acid from glycine-N15 in primary and secondary polycythemia . Am J Med 21:901-917, 1956.Crossref 4. Talbott JH: Gout and blood dyscrasias . Medicine 38:173-205, 1959. 5. Denman AM, Szur L, Ansell BM: Hyperuricaemia in polycythaemia vera . Ann Rheum Dis 25:340-344, 1966. 6. Lesch M, Nyhan WL: A familial disorder of uric acid metabolism and central nervous system function . Am J Med 36:561-570, 1964.Crossref 7. Yü TA-F, Gutman AB: Uric acid nephrolithiasis in gout: Predisposing factors . Ann Intern Med 67:1133-1148, 1967.Crossref 8. Yü TA-F, Gutman AB: Effect of allopurinol (4-hydroxypyrazolo-(3,4-d) pyrimidine) on serum and urinary uric acid in primary and secondary gout . Am J Med 37:885-898, 1964.Crossref 9. Band PR, Silverberg DS, Henderson JF, et al: Xanthine nephropathy in a patient with lymphosarcoma treated with allopurinol . N Engl J Med 283:354-357, 1970.Crossref 10. Greene ML, Fujimoto WY, Seegmiller JE: Urinary xanthine stones—a rare complication of allopurinol therapy . N Engl J Med 280:426-427, 1969.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1978 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1978.02120340076016
Publisher site
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Abstract

Abstract β Gout is rarely noted as a clinical problem in secondary polycythemia—even if profound polycythemia exists, as in cyanotic congenital heart disease. A retrospective study of 81 patients with congenital heart disease was done to assess the incidence of hyperuricemia. Twenty of 46 patients with cyanotic congenital heart disease had serum levels of uric acid greater than 8 mg/dl. Thirteen of 16 (81%) cyanotic male patients more than 15 years old had serum levels greater than 8 mg/dl. For cyanotic patients, serum levels of uric acid were related directly to the degree of polycythemia (r =.44; P <.02). Impaired renal function or drug therapy did not seem to account for the hyperuricemia. Because levels of uric acid greater than 10 mg/dl probably are nephropathic, many of these patients may be incurring subclinical uric acid nephropathy. (Am J Dis Child 132:900-902, 1978) References 1. Wyngaarden JB: The etiology and pathogenesis of gout , in Hollander JL, McCarty DJ Jr (eds): Arthritis and Allied Conditions: A Textbook of Rheumatology , ed 8. Philadelphia, Lea & Febiger Inc, 1972, p 1095. 2. Somerville J: Gout in cyanotic congenital heart disease . Br Heart J 23:31-34, 1961.Crossref 3. Yü TF, Weissman B, Sharney L, et al: On the biosynthesis of uric acid from glycine-N15 in primary and secondary polycythemia . Am J Med 21:901-917, 1956.Crossref 4. Talbott JH: Gout and blood dyscrasias . Medicine 38:173-205, 1959. 5. Denman AM, Szur L, Ansell BM: Hyperuricaemia in polycythaemia vera . Ann Rheum Dis 25:340-344, 1966. 6. Lesch M, Nyhan WL: A familial disorder of uric acid metabolism and central nervous system function . Am J Med 36:561-570, 1964.Crossref 7. Yü TA-F, Gutman AB: Uric acid nephrolithiasis in gout: Predisposing factors . Ann Intern Med 67:1133-1148, 1967.Crossref 8. Yü TA-F, Gutman AB: Effect of allopurinol (4-hydroxypyrazolo-(3,4-d) pyrimidine) on serum and urinary uric acid in primary and secondary gout . Am J Med 37:885-898, 1964.Crossref 9. Band PR, Silverberg DS, Henderson JF, et al: Xanthine nephropathy in a patient with lymphosarcoma treated with allopurinol . N Engl J Med 283:354-357, 1970.Crossref 10. Greene ML, Fujimoto WY, Seegmiller JE: Urinary xanthine stones—a rare complication of allopurinol therapy . N Engl J Med 280:426-427, 1969.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Sep 1, 1978

References