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- Title
Modern diagnostic approach to hereditary xanthinuria.
- Authors
Mraz, Martin; Hurba, Olha; Bartl, Josef; Dolezel, Zdenek; Marinaki, Anthony; Fairbanks, Lynette; Stiburkova, Blanka
- Abstract
Hereditary xanthinuria (HX) is a rare inherited disorder caused by a deficiency of xanthine dehydrogenase/oxidase (XDH/XO). Missing XDH/XO activity leads to undetectable levels of uric acid excessively replaced by xanthine in serum/urine. The allopurinol loading test has been traditionally used to differentiate between HX types I and II. Final confirmation of HX has been based on the biopsy finding of the absent XDH/XO activity in the small intestine or liver. We present the clinical, biochemical, ultrasound and molecular genetics findings in three new patients with HX and suggest a simple three-step approach to be used for diagnosis, typing and confirmation of HX. In the first step, the diagnosis of HX is determined by extremely low serum/urinary uric acid excessively replaced by xanthine. Second, HX is typed using urinary metabolomics. Finally, the results are confirmed by molecular genetics. We advocate for this safe and non-invasive diagnostic algorithm instead of the traditional allopurinol loading test and intestinal or liver biopsy used in the past.
- Subjects
XANTHINURIA; XANTHINE dehydrogenase; GENETIC disorder diagnosis; GENETIC disorders; MOLECULAR genetics; ALLOPURINOL; LIVER biopsy; PATIENTS
- Publication
Urolithiasis, 2015, Vol 43, Issue 1, p61
- ISSN
2194-7228
- Publication type
Article
- DOI
10.1007/s00240-014-0734-4