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July 1, 1950


JAMA. 1950;143(9):806-807. doi:10.1001/jama.1950.82910440003010b

In a patient in whom anuria developed after radiation therapy for chronic lymphatic leukemia the anuria was caused by complete obstruction of both ureters with uric acid crystals. Although the metabolic processes in this sequence of events are well known, a case of anuria of this type could not be found in the literature.

It is recognized that there is an increase in the uric acid metabolism of patients suffering from leukemia. Radiotherapy causes the destruction of many white blood cells and the subsequent liberation of enormous amounts of nucleoproteins, resulting in an excessive increase in the production of uric acid. This leads to hyperuricacidemia, uric acid crystalluria and actual stone formation, a potential danger following radiation therapy in leukemia.

Although the mechanism involved is easily understood, it is doubtful whether these complications are fully appreciated and watched for in the routine treatment of leukemia. Merrill1 has reported 5

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