"Acute Hyperuricemia Secondary to Epileptic Seizures Leading to Acute Urate Nephropathy: A Case report"

Abstract

BackgroundAbout two third of the body uric acid is produced endogenously while the rest of one third is from dietary products containing purines. Most of the uric acid is excreted through kidneys while the remaining through intestines. Hyperuricemia occurs either due to underexcretion of urate or overproduction of urate. Factors that predominantly effect uric acid excretion include tubular fluid Ph, tubular fluid flow rate and renal blood flow. Acute hyperuricemia can lead to acute uric acid nephropathy by renal tubular obstruction by urate and uric acid crystals which can lead to significant morbidity.Seizures is an exceedingly uncommon cause of acute hyperuricemia. This is one such case of a patient with Generalized tonic clonic fits leading to acute hyperuricemia which in turn caused acute urate nephropathy. Case PresentationA 35-year-old man with no premorbid presented in emergency department with generalized tonic clonic fits. At presentation patient had Bp of 130/70, Pulse 96, Temperature 98.7F, Oxygen saturation 97% with room air. Blood sugar random was 126mg/dl.He had two such episodes in last 30 minutes. Abortive therapy was given to control the fits. After initial management detail examination was done. Central nervous system examination was normal with no focal neurological deficit. Chest was clear bilaterally with rest of respiratory examination normal. Cardiovascular, Gastrointestinal and musculoskeletal examination was also normal. Complete blood picture showed leukocytosis with white blood cell count