Hyperuricemia is sometimes associated with various blood dyscrasias including leukemia and lymphoma, while it is rarely found in patients with nonlymphomatous solid tumors. We reported two cases of hyperuricemic renal failure caused by solid malignant tumors. Case 1 was 51-year-old male of esophagus cancer. Laboratory data on admission were as follows: BUN,69.4 mg/dl; serum creatinine,3.8 mg/dl; uric acid,26.5 mg/dl; and LDH,1960 IU. He was treated with peritoneal dialysis. Case 2 was 60-year-old female of gastric cancer, who showed the following laboratory data: BUN,78.1 mg/dl; serum creatinine,3.1 mg/dl; uric acid,26.2 mg/dl; and LDH,624 IU. Statistical analysis was performed on 100 patients with nonlymphomatous solid tumor. Hyperuricemia was found in 6 % of them. Hyperuricemic patients were demonstrated to have elevated blood urea nitrogen and creatinine. Furthermore, they had raised levels of GOT, LDH, total bilirubin and alkaline phosphatase, being signicantly higher (p<0.001)than normouricemics. All of six hyperuricemic patients had massive liver metastasis. Hyperuricemia associated with solid tumor could be related to the presence of widespread massive metastasis, especially the involevement of liver.
Intensive muscle exercise occasionally lead to hyperuricemia and/or uricosuria in man. However, these mechanism is not quite uncle ar. Recently we had a oppotunity to study the prevalance of gout and hyperuricmia on two preofessional baseball teams in Tokyo. Unusual high incidence of gout hyperuricemia, increasing of serum CPK was revealed throughout this study. The results are following. 1) The prevalance of gout 3,3 % and it of hyperuricemia was 34.0 %. The prevalance was up to 54.2 % among major Teague players. This incidence of gout was about 10 times higher than it of the s ame age normal population in Tokyo. In addition, serum creatini n e and BUNw as also more increased among these major league players than retired staff and or farm team players. (Table-2) 2) 97.1 % of the subjects showed increasing of the serum CPK level and mean value of active playsers was four to eig ht times higher than normal adults. 3) Serum uric acid highly increased during 5 mounths intensive muscle exercise among 20 farm-team players. (Table- 3)
Recently the American Rheumatism Association Comittee on classification criteria for gout reported the "preliminary criteria for the classification of the acute arthritis of primary gout. We assesed this diagnostic criteria from clinical, epidemiological situation, to classify the acute gouty arhtritis from other arthritis. The data were obtained from 30 gouty patients and 30 patients with rheumatoid arhtritis (RA) whose diagnosis was established under classical diagnostic criteria. On the other hand, we added 10 cases with gout whose informations were obtained in our previous population study. The results were following. Five or more criteria of 11 criteria were found in 96.5 % of the patients with primary gout and in 5.9 % of the patients with early stage of RA.6 or more of the eleven criteria were found 86.6 %of the patients with primary gout and none of in other arthritis. From our these data we would like agree with the opinion which was mentioned by original outhers of this criteria. So, if the six or more of eleven criteria were found in a patients, it may be acceptable that the patient is diagnosed as a primary gout both clinical and epidemiological study.