Hyperuricaemia : Akuarit 4

Availability: 

• per Tab Ethambutol HCl 275 mg, rifampicin 150 mg, isoniazid 75 mg, pyrazinamide 400 mg

Most likely causative agent:

• Pyrazinamide

Management

• As a result of inhibition of renal tubular secretion, a degree of hyperuricaemia usu­ally occurs,  but this is often asymptomatic.
• Arthralgia, particularly of the shoulders, may occur and is responsive to simple analgesics (especially aspirin).
• Both hyperuricaemia and ar­thralgia may be reduced by prescribing regimens with intermittent administration of pyrazinamide.
• Acute liver damage and hyperuricaemia have been reported in cases of overdosages

Treatment

• Gout requiring treatment with allopuri­nol occasionally develops.
• Asymptomatic hyperuricemia is common and treatment is generally unnecessary.
• The diagnosis of gout requires confirmation of the presence of monosodium urate crystals in synovial fluid
• Pyrazinamide and ethambutol-induced hyperuricemia can normally be controlled by xanthine oxidase inhibitors

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189695/

References:

1. WHO Treatment of tuberculosis: guidelines – 4th ed / 2010 
2. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4189695/
3. http://www.medscape.com/viewarticle/562264_2