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Hypouricemia and Renal Tubular Urate Secretion

Agustin Munoz Sanz, MD, PhD; Gabriel Gaspar Alonzo-Vega, MD, PhD; Felicítas Mateos Antón, MD, PhD; Juan Garcia Puig, MD, PhD
Arch Intern Med. 1983;143(8):1633-1634. doi:10.1001/archinte.1983.00350080155041.
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To the Editor.  —We read with interest the article entitled "Hypouricemia due to an Increment in Renal Tubular Urate Secretion" by Shichiri et al published in the October 1982 Archives (142:1855-1857). These authors described two patients with hypouricemia due to augmented uric acid clearance that was greatly increased by the administration of oral probenecid therapy. They concluded that increased urate secretion by the renal tubule was probably responsible for the hypouricemia of both patients and, to their knowledge, this is the first description of increased tubular urate secretion as a variety of renal hypouricemia.At the Fourth International Symposium on Human Purine and Pirimidine Metabolism (Maastricht, the Netherlands, June 1982), we described five patients with hyperuricosuria who had recurrent nephrolithiasis and who did not normalize their uric acid excretion while receiving an essentially purine-free diet.1 Furthermore, all were hypouricemic and showed evidence of an abnormal uricosuric response when given


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