Hyperuricemia Associated With the Treatment of Acute Leukemia

ELEVATIONS of serum and urinary concentrations of uric acid have been described in acute leukemia.1'2 It is also known that, with therapy, urate excretion may rise.3'4'5'6 Recently the authors have had an opportunity to view two patients who showed a marked degree of hyperuricemia con-comitant with therapy of their acute lymphocytic leukemia. The authors thought that a review of these cases might point out a hazard in treating these patients. CASE REPORTS Case 1. A 50 year old white female housewife had been well until the winter of 1954, when she developed unusual fatigue and a low grade fever. She was ad-mitted to the George Washington Hospital, Washington, D. C, on July 20, 1955, where hepatosplenomegaly and lymphocytosis were noted, and sternal marrow aspira-tion revealed acute lymphocytic leukemia. The patient received 6-mercaptopurine for three days and cortisone for 19 days, with clinical improvement. At this time she noted symptoms of a urinary tract infection and, although the urine culture was