A number of conditions other than hereditary renal hypouricemia can result in hypouricemia.
Diagnosis: serum uric acid below the lower limit of normal (< 2 mg/dL) without evidence of hereditary renal hypouricemia
Conditions associated with uricosuria:
(1) Fanconi syndrome
(2) Wilson's disease
(3) SIADH
(4) malignancy
(5) diabetes mellitus
(6) pregnancy
(7) severe diarrhea
(8) renal tubular acidosis
Conditions associated with underproduction of uric acid:
(1) xanthinuria
(2) molybdenum cofactor deficiency
(3) purine nucleoside phosphorylase deficiency
(4) PRPP synthetase hypoactivity
(5) idiopathic underproduction of uric acid
(6) severe hepatic injury
(7) severe malnutrition
Drugs associated with hypouricemia:
(1) allopurinol
(2) febuxostat
(3) pegloticase (recombinant uricase)
(4) probenecid
(5) benzbromarone
(6) lesinurad (urate transporter inhibitor)
(7) angiotensin II receptor blocker
(8) fenofibrate
(9) high-dose trimethoprim-sulphamethoxazole
(10) NSAIDs
(11) high-dose salicylate therapy
Differential diagnosis:
(1) technical problem with measuring uric acid, including specimen dilution
