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MR Vol.10 No.4 indexに戻る
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MODERN RHEUMATOLOGY
Vol.10 No.4 |
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Latent overproductive hyperuricemia increases
in patients during the intermittent phase of gouty arthritis under
long-term antihyperuricemic treatment
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| H. Tsutani1, C. Kiriba1, S. Imamura1, N.
Yoshio1, T. Nakamura , T. Ueda1 |
(1) First Department of Internal Medicine, Fukui
Medical University, School of Medicine, 23-3 Shimoaizuki, Matsuoka,
Fukui 910-1193, Japan
(2) Hayashi General Hospital, Fukui, Japan |
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| Abstract |
| Abstract This work was undertaken to determine
baseline urate metabolism in patients during the intermittent phase
of gouty arthritis in order to decide on the best treatment for
hyperuricemia. Parameters affecting serum urate levels, including
uric acid clearance and urinary urate excretion, were re-evaluated
in 30 patients who had shown normouricemia and no gouty attacks
for at least 1 year and who were receiving urate-lowering drugs.
The parameters determined at 2 weeks after discontinuation of the
treatment (re-evaluation) were compared with those determined at
initial diagnosis (initial evaluation). The discontinuation of
urate-lowering drugs at re-evaluation led to a hyperuricemic state
in all patients. The serum urate levels at re-evaluation were significantly
higher than those at initial evaluation. The mean quantity of urinary
urate excretion in patients showing increases in serum urate levels
and the number of patients classified with overproductive hyperuricemia
increased at re-evaluation. There was a significant increase in
%-glutamyl transpeptidase level, but no changes in body weight
or creatinine and uric acid clearance. Asymptomatic patients at
intermittent phases of gout may be in a latent, but progressing,
hyperuricemic state as a result of urate overproduction. Physicians
should assess latent hyperuricemia periodically, and choose a treatment
with xanthine oxidase inhibitor when necessary. |
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| Key words |
Key words Uricosuric agents ・ Allopurinol ・ Prevention and control
・ Differential diagnosis ・ Patient education
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