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Query: UMLS:C0018099 (
gout
)
5,192
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
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 less than .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.
...
PMID:Hyperuricemia in congenital heart disease. 68 9
Uric acid is the end-product of purine nucleotide metabolism in man. The renal handling of urate is a complicated process, resulting in a fractional clearance of 8.2-10.3%. The anhydrous form is thermodynamically the most stable uric acid crystal. Uric acid is a weak acid that ionizes with a Pka at pH 5.75. At the normal acidic region, uric acid solubility is strongly increased by urinary pH. The prevalence of uric acid stones varies between countries, reflecting climatic, dietary, and ethnical differences, ranging from 2.1% (in Texas) to 37.7% (in Iran). The risk for uric acid stone formation correlates with the degree of uric acid supersaturation in the urine, depending on uric acid concentration and urinary pH. Hyperuricosuria is the major risk factor, the most common cause being increased purine intake in the diet. Acquired and hereditary diseases accompanied by hyperuricosuria and stone disease include:
gout
, in strong correlation with the amount of uric acid excreted, myelo- and lymphoproliferative disorders, multiple myeloma,
secondary polycythemia
, pernicious anemia and hemolytic disorders, hemoglobinopathies and thalassemia, the complete or partial deficiency of HGPRT, superactivity of PRPP synthetase, and hereditary renal hypouricemia. A common denominator in patients with idiopathic and gouty stone formers is a low urinary pH. Uric acid nephrolithiasis is indicated in the presence of a radiolucent stone, a persistent undue urine acidity and uric acid crystals in fresh urine samples. A radiolucent stone in combination with normal or acidic pH should raise the possibility of urate stones.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:Uric acid nephrolithiasis. 778 6
Several health hazards and social disabilities are associated with obesity. Increased mortality is associated with increased body weight. A high rate of mortality results from heart disease, diabetes mellitus, gallbladder disease, high blood pressure, and cancer. Physiologic cardiovascular changes occur, leading to left ventricular hypertrophy and lipid abnormalities. Hypertension, stroke, and venous stasis are increased. Pulmonary abnormalities include obstructive sleep apnea, which can be associated with
secondary polycythemia
and right ventricular hypertrophy. Gallstones, gallbladder disease, and accumulation of fat on the liver are significantly increased.
Gout
and reproductive abnormalities in women are common. Osteoarthritis of the knees and spine occur, although osteoporosis is rare. Risk for endometrial and breast cancer is increased, particularly in the presence of increased central fat. Changes in the skin include stretch marks, acanthosis negricans, hirsutism, intertrigo, and multiple papillomas. Impaired psychosocial function is manifested as social isolation, loss of job mobility, increased employee absenteeism, and economic and social discrimination.
...
PMID:Health hazards of obesity. 897 52
An investigation was made of the serum uric acid in 130 male patients with long-standing cardiac or pulmonary disease. The mean serum uric acid was 4.66 mg. per 100 ml. with a standard deviation of +/-0.99. The serum uric acid increased parallel with a rise in the haemoglobin level. The coefficient of correlation was +0.5, which was nearly six times the standard error. The frequency of hyperuricaemia (over 6 mg. per 100 ml.) was 11 times in 47 patients with a haemoglobin level above 110% as compared with twice in 83 patients when the haemoglobin level was below this figure. The highest levels of serum uric acid were seen in patients with cyanotic congenital heart disease. Two of the patients with hyperuricaemia gave a suggestive history of
gout
, and this was believed to have been caused by the
secondary polycythaemia
. Serum uric acid levels were significantly higher, as were the haemoglobin concentrations, in the obese compared with the patients who were not obese.
...
PMID:The relation of serum uric acid to haemoglobin level in patients with cardiac and respiratory disease. 1376 22