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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated Uric Acid Levels While On AKT4 For Tuberculosis?

I am suffrind from Tuberclosis The ADA test shows 62.7 Now am taking AKT 4 from last 14 days And today i did the test for serum uric acid amd it shows that its 9.2 . So can you please explain why its incresed ? Its due to anti tB drugs or what ?
Wed, 20 Nov 2019
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General & Family Physician,  's  Response
Many medications have been associated with elevated uric acid levels. Pyra zinamide and ethambutol are two anti tuberculous drugs that have been reported to induce hyperuricemia.
Pyrazinamide is a strong urate retention agent, causing a greater than 80% reduction in renal clearance of uric acid at a 300-mg therapeutic daily dose.
The metabolite pyrazinoic acid is oxidized by xanthine oxidase and is likely responsible for the hyperuricemic effect.
Hyperuricemia has been reported in 43% to 100% of patients treated with pyrazinamide (alone or in combination).6,9 Furthermore, gouty attacks have been associated with patients taking pyrazinamide.
Ethambutol can also cause hyperuricemia by decreasing renal uric acid clearance, but it does so less consistently and to a lesser degree than pyrazinamide.
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What Causes Elevated Uric Acid Levels While On AKT4 For Tuberculosis?

Many medications have been associated with elevated uric acid levels. Pyra zinamide and ethambutol are two anti tuberculous drugs that have been reported to induce hyperuricemia. Pyrazinamide is a strong urate retention agent, causing a greater than 80% reduction in renal clearance of uric acid at a 300-mg therapeutic daily dose. The metabolite pyrazinoic acid is oxidized by xanthine oxidase and is likely responsible for the hyperuricemic effect. Hyperuricemia has been reported in 43% to 100% of patients treated with pyrazinamide (alone or in combination).6,9 Furthermore, gouty attacks have been associated with patients taking pyrazinamide. Ethambutol can also cause hyperuricemia by decreasing renal uric acid clearance, but it does so less consistently and to a lesser degree than pyrazinamide.