HPRT-related hyperuricemia with a novel p.V35M mutation in HPRT1 presenting familial juvenile gout

Eikan Mishima, Takayasu Mori, Yoko Nakajima, Takafumi Toyohara, Koichi Kikuchi, Yoshitsugu Oikawa, Tetsuro Matsuhashi, Yasuhiro Maeda, Takehiro Suzuki, Masataka Kudo, Sadayoshi Ito, Eisei Sohara, Shinichi Uchida, Takaaki Abe

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Abstract

Unlike complete deficiency of hypoxanthine phosphoribosyltransferase (HPRT) (i.e., Lesch-Nyhan syndrome), partial HPRT deficiency causes HPRT-related hyperuricemia without neurological symptoms. Herein, we describe a 22-year-old man without neurological symptoms that presented gout, hyperuricemia (serum urate level, 12.2 mg/dL), multiple renal microcalculi, and a family history of juvenile gout that was exhibited by his brother and grandfather. Genetic testing revealed a novel missense mutation, c.103G>A (p.V35M), in the HPRT1 gene, and biochemical testing (conducted using the patient's erythrocytes) showed that the patient retained only 12.4% HPRT enzymatic activity compared to that exhibited by a healthy control subject. We thus diagnosed the patient with HPRT-related hyperuricemia caused by partial HPRT deficiency. After his serum urate level was controlled via treatment with febuxostat, his gout did not recur. Thus, this study emphasizes that HPRT deficiency should be considered as a potential cause of familial juvenile gout, even in the absence of neurological symptoms.

Original languageEnglish
Pages (from-to)210-214
Number of pages5
JournalCEN case reports
Volume9
Issue number3
DOIs
Publication statusPublished - 01-08-2020

All Science Journal Classification (ASJC) codes

  • Nephrology

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    Mishima, E., Mori, T., Nakajima, Y., Toyohara, T., Kikuchi, K., Oikawa, Y., Matsuhashi, T., Maeda, Y., Suzuki, T., Kudo, M., Ito, S., Sohara, E., Uchida, S., & Abe, T. (2020). HPRT-related hyperuricemia with a novel p.V35M mutation in HPRT1 presenting familial juvenile gout. CEN case reports, 9(3), 210-214. https://doi.org/10.1007/s13730-020-00459-9