A patient with a history of gout and lymphoma undergoes chemotherapy. What is the most likely mechanism by which chemotherapy can exacerbate gout?
Group of answer choices
- By stimulating the immune system to produce more uric acid
- By causing lysis of cells and subsequent release of purines
- By increasing the excretion of uric acid through renal tubular acidosis
- By disrupting the balance of pro-inflammatory and anti-inflammatory cytokines
The correct answer is:
By causing lysis of cells and subsequent release of purines
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Explanation:
Chemotherapy, especially in patients with high tumor burden (such as those with lymphoma), can lead to tumor lysis syndrome, in which rapid destruction of malignant cells releases large amounts of nucleic acids (purines). These purines are then metabolized into uric acid, which can accumulate and precipitate, worsening gout or causing acute uric acid nephropathy.
