Hyperuricemia: a marker for cell energy crisis.

The underlying cause of hyperuricemia is often obscure. Why are serum urate levels markedly elevated in some acutely ill patients in the intensive care unit?1 What lies behind reports of uric acid nephropathy after heavy exertion?2 What is the association between ethanol ingestion and hyperuricemia?3 Why is gout characteristic of glycogen storage disease?4 The development of hyperuricemia in these apparently unrelated clinical situations, as well as many others, appears to be explained by a single pathogenetic mechanism, the net degradation of ATP.5 6 7 ATP is a ubiquitous, intracellular, high-energy phosphate compound involved in intermediate metabolism. Its synthesis and consumption are dynamic . . .

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