Arthalgia Type 1
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Arthalgia Type 2
(Gouty Arthritis)
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Possible Causative Agent
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pyrazinamide>>ethambutol> isoniazid
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pyrazinamide>>ethambutol
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Clinical Presentation
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Management
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Proposed Mechanism
- A metabolite of pyrizinamide, pyrinazoic acid, inhibits the renal tubular secretion of uric acid and ethambutol reduces its renal clearance.
- The resulting hyperuricaemia can give rise to arthralgias and very rarely an arthritis.
Reference;
- http://rheumatology.oxfordjournals.org/content/45/9/1173.full
- http://www.uphs.upenn.edu/TBPA/treatment/managingsideeffects.pdf
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