| Acute Uric Acid Nephropathy
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Etiology
•Associated with:
•Highly malignant neoplasms with rapid
turnover as in Burkitt's lymphoma.
•Tumor lysis syndrome due to
chemotherapy.
•Breakdown of extramedullary hematopoietic cells in the
first few days of an infant's life.
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Pathogenesis
•High serum uric acid levels (>20mg/dl)
especially in the setting of dehydration and acidemia leads to precipitation
and accumulation of urates in the collecting ducts of the kidney.,
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Epidemiology
•See etiology.
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General Gross Description
•On section, the renal papillae show yellow radiating striations
reflecting the anatomic arrangement of the collecting ducts in the medullary
pyramid.
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General Microscopic Description
•Histology shows luminal obstruction of the distal tubules and
collecting ducts by urate crystals.
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Clinical Correlation
•Acute uric acid nephropathy occurs when there is a sudden massive
breakdown of nucleated cells, as in tumor lysis syndrome when chemotherapy
is instituted.
•This condition can also occur in infants during the first
few days of life when extramedullary hematopoietic cells
breakdown.
•Clinically, renal manifestation can be that of acute renal
failure.
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References
• Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 974-975.
•Primer of Kidney Diseases (National Kidney
Foundation), 1994, Arthur Greenberg editor.
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| Acute Uric Acid Nephropathy
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| Synopsis by: Harold Yamase M.D. (T71000M30040)[239]
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