Association between hypouricaemia and jaundice.

During routine biochemical screening of over 4,000 patients admitted to the Veterans Administration Wadsworth Hospital Center, a small number were found to have serum urate concentrations below 2-2 mg/100 ml. Most of these patients had profound illness, including severe hepatic involvement with jaundice. It is known that circulating bilirubin is highly bound to proteins (Odell, 1959). Previous studies if this laboratory have shown that many protein-bound anions may displace protein-bound urate in vitro and may have a uricosuric effect when given to patients with hyperuricaemia or to normal volunteers (Bluestone, Kippen, and Klinenberg, 1969; Klinenberg, Bluestone, Schlosstein, Waisman, and Whitehouse, 1973). Therefore, a study of urate excretion and plasma binding of urate in transiently jaundiced patients was undertaken to investigate any direct relationship between hyperbilirubinaemia and hypouricaemia. Additional experiments were performed with rats that were madejaundiced by ligation of the common bile duct.