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February 1969

Hyperuricemia Complicating LeukemiaTreatment With Allopurinol and Dialysis

Author Affiliations

Washington, DC

From the Department of Medicine, Georgetown University School of Medi-; cine, Washington, DC.

Arch Intern Med. 1969;123(2):198-200. doi:10.1001/archinte.1969.00300120086014

Hyperuricemia is a known, potentially fatal complication of leukemia, particularly following therapy of the acute process. Hydration, solute diuresis, and alkalinization of the urine often are sufficient to allow the kidneys to excrete the increased load of uric acid.1 Despite this therapy, uric acid crystallization may occur which can be relieved by cystoscopy and alkali lavage of the renal pelvis. Severe hyperuricemia causing urate crystallization and anuria may require therapy with dialysis.1-5 This complication of leukemia and lymphoma is best treated by a prevention of uric acid synthesis using the xanthine oxidase inhibitor, allopurinol, as described by Rundles and associates.6 Unfortunately, acute leukemia often is abrupt in its onset of exacerbations, and hyperuricemia may be an early manifestation. The patient to be described is the first example in whom neither dialysis nor allopurinol alone were sufficient to alleviate the hyperuricemia, but combined therapy corrected the hyperuricemia, restored

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