Mechanism
- hyperuricaemia - may occur prior to treatment of myeloid tumours but usually occurs after treatment has started, when there is rapid lysis of malignant cells, release of large amounts of nucleoprotein and an increase in production of uric acid.
- renal failure may occur as a result of intra- and/or extra- renal obstruction caused by deposition of uric acid crystals in the collecting ducts, pelvis and ureters (ureteric obstruction may respond to retrograde ureteric catheterization and lavage)
- usual site for uric acid crystal deposition is the renal tubules
Plasma urate levels are raised (above 0.75 mmol/l and as high as 4.5 mmol/l).
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