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| Acute Uric Acid Nephropathy | ||
| 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. | ||
| 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., | ||
| Epidemiology •See etiology. | ||
| General Gross Description •On section, the renal papillae show yellow radiating striations reflecting the anatomic arrangement of the collecting ducts in the medullary pyramid. •Examples: | ||
| General Microscopic Description •Histology shows luminal obstruction of the distal tubules and collecting ducts by urate crystals. •Examples: | ||
| 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. | ||
| 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. Please be patient during transfer. Medline will open in a new window. To return, close the Medline Window Acute Uric Acid Nephropathy
| Synopsis by: Harold Yamase M.D. (T71000M30040)[239]
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