Hyperuricemia, endogenous


Primary hyperuricemia

  • Increased production of purine
  1. Idiopathic
  2. Specific enzyme defects (eg, Lesch-Nyhan syndrome, glycogen storage diseases)
  • Decreased renal clearance of uric acid (idiopathic)

Secondary hyperuricemia

  • Increased purine catabolism and turnover
  1. Myeloproliferative disorders
  2. Lymphoproliferative disorders
  3. Carcinoma and sarcoma (disseminated)
  4. Chronic hemolytic anemias
  5. Cytotoxic drugs
  6. Psoriasis
  • Decreased renal clearance of uric acid
  1. Intrinsic kidney disease
  2. Functional impairment of tubular transport:
  • Drug-induced (eg, thiazides, probenecid)
  • Hyperlacticacidemia (eg, lactic acidosis, alcoholism)
  • Hyperketoacidemia (eg, diabetic ketoacidosis, starvation)
  • Diabetes insipidus (vasopressin-resistant)
  • Bartter's syndrome

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Last updated: December 1, 2014