tailieunhanh - Báo cáo y học: "Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout Lisa Cammalleri and Mariano Malaguarnera"

Tuyển tập các báo cáo nghiên cứu khoa học ngành y học tạp chí Medical Sciences dành cho các bạn sinh viên ngành y tham khảo đề tài: Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout Lisa Cammalleri and Mariano Malaguarnera. | Int. J. Med. Sci. 2007 4 83 International Journal of Medical Sciences ISSN 1449-1907 2007 4 2 83-93 Ivyspring International Publisher. All rights reserved Review Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout Lisa Cammalleri and Mariano Malaguarnera Dept of Senescence Urological and Neurological Sciences University of Catania Catania Italy Correspondence to Mariano Malaguarnera . Via Messina 829 - 95125 Catania Italy . Phone 39 95 7262008 Fax 39 95 7262011 E-Mail malaguar@ Received Accepted Published Hyperuricemia is a feature of several pathologies and requires an appropriate and often early treatment owing to the severe consequences that it may cause. A rapid and massive raise of uric acid during tumor lysis syndrome TLS and also a lower and chronic hyperuricemia as in gout mainly damage the kidney. To prevent or treat these consequences a new therapeutic option is represented by rasburicase a recombinant form of an enzyme urate oxidase. This enzyme converts hypoxanthine and xanthine into allantoin a more soluble molecule easily cleared by kidney. The several types of urate oxidase have followed each other with progressive reduction of adverse reactions. The most important among them are allergenicity and the development of antibodies which compromise their effectiveness. Nevertheless a limit of rasburicase s use remains its cost which obliges to a judicious choice to prevent TLS in high risk patients with cancer and in case of allergy or impossibility to take allopurinol orally both in TLS and in gout. A large body of evidence confirms the efficacy and safety of rasburicase even in comparison to the standard drugs used in the aforementioned pathologies. Key words Urate oxidase allantoin rasburicase hyperuricemia tumor lysis syndrome acute renal failure gout allopurinol uric acid 1. Introduction Uric acid is a weak organic acid pKa poorly water-soluble at .