URIC ACID

BY

SAJJAD AHMAD

INTRODUCTION
Uric acid is the product of catabolism

of purine nucleic acid.

Uric acid is relatively insoluble in

plasma and, at high concentration, can be deposited in the oints and tissue, causing painful inflammation.

!hysiology

!urine, such as adenosine and guanine from the brea"do#n of ingested nucleic acids or from tissue destruction, are converted into uric acid, primarily in the liver. the "idney, #here it is filtered by the glomerulus.

Uric acid is transported in plasma from the liver to Renal e$cretion accounts for about %&' of uric

acid elimination( the remainder passes into the gastrointestinal tract and is degraded by bacterial en)ymes.

!hysiology *+
Nearly all of the uric acid in plasma is present

as monosodium urate.
,t the p- of .p-/%0, urate is relatively

insoluble( at concentrations greater than 1.2 mg*d3, the plasma is saturated. ,s a result urate crystals may form and precipitate in the tissues.

-yperuricemia
Increased level of uric in blood is called

hyperuricemia
4ollo#ing are conditions in #hich uric acid is

increased.

C,U565 O4 ,7NOR8,3 !3,58, URIC ,CID

Increased concentration
6n)yme deficiences such as 3esch9Nyhan syndrome :lycogen storage disease 4ructose intolerance :out Treatment of myeloproliferative disease #ith cytoto$ic drugs Chronic renal disease 3actic acidosis !urine rich diet Increased tissue catabolism or starvation

Decreased concentration
3iver disease 4anconi syndrome .Defective tubular

reabsorption0
Overtreatment #ith allopurinol

-yperuricemia

.Increased level of uric acid in blood0

3esch9Nyhan syndrome is an ;9lin"ed genetic

disorder caused by the complete deficiecy of hypo$anthine guanine phosphoribosyltransferase, an important en)yme in the biosynthesis of purines. 3ac" of this en)yme prevents the reutili)ation of purine bases and results in increased denovo synthesis of purine neclutides and high plasma and urine concentrations of uric acids.

Increased uric acid is found 5econdary to glycogen storage diseases .Deficiency of glucose 19phosphatase0 4ructose intolerance .deficiency of fructose9<9 phosphate aldolase0. 8etabolites such as lactate and triglycerides are produced in e$cess and compete #ith urate for renal e$cretion in these diseases.

6levated uric acid concentration is found in

Renal disease Increased catabolism of nucleic acid and :out

:out is a disease found primarily in men and affected individuals have pain and inflammation of the oints caused by precipitation of sodium urates. !atients #ith gout are very succesptible to the development of renal calculi.
In

#omen, urate concentration rises after menopause. !ostmenopausal #omen may develop hyperuricemia and gout. In severe cases, deposits of crystalline of uric acid and urates called tophi form in tissue, causing deformities.