THE ENDOGENOUS URIC ACID METABOLISM IN PERNICIOUS ANEMIA

Abstract

Before treatment, in patients with pernicious anemia in a complete relapse, using a purine poor diet, the concentration of uric acid in the fasting blood serum varies considerably but usually is normal or less than normal. Normal amounts of uric acid are eliminated in the urine before treatment in uncomplicated cases. The uric acid metabolism behaves in a very characteristic manner during early remission whether remission is spontaneous or is induced by liver extract. There is a prompt increase of the amount of uric acid excreted, which is, as a rule, apparent within the first 24 hrs. of treatment. During the first 2 wks. of treatment, the fluctuations of the uric acid metabolism follow those of the numbers of reticulo-cytes in the blood. In the succeeding period, the uric acid metabolism rises to an elevated level which is maintained, within the periods of observation, as long as treatment continues. The increased uric acid metabolism during early remission is endogenous in origin and is not accompanied by any outstanding abnormalities in the general N metabolism. The destruction of large numbers of red blood cell nuclei which accompanies the rapid maturation of red blood cells and an increase in general nuclear metabolism throughout the body are advanced as factors which may contribute to the increased uric acid metabolism in pernicious anemia during early remission.