Clinical Cases Of Nucleotide Metabolism

Question 1

Gout

Answer 1

1) Pain in toe due to alcohol consumption.
2) affected area is swollen, tender and warm.
3) Administration of allopurinol relived from pain.
4) High serum uric acid level.

Deposition of sodium monourate crystals takes place.
Uric acid is end product of purine nucleotide which is responsible for gout.

Alcohol metabolism in liver produces excess NADH . It causes conversion of pyruvate to lactate causing lactic acidosis which impairs metabolism and excretion of uric acid causing gout.

Allopurinol is converted in alloxanthine by xanthine oxidase which in turn reduces action of xanthine oxidase and is sucide inhibition.

Question 2

Lesch Nyhan syndrome

Answer 2

Biting of lips and fingers
Involuntary movement of upper limb
Orangish discoloration of diapers
Increased serum uric acid level.

Question 3

5- fluorouracil and mechanisms of its action.

Answer 3

Lower abdominal pain
Blood in stools
Loss of appetite and loss of weight
Colonoscopy revealed adrenocarcinoma
5- fluorouracil was prescribed which inhibits conversion of dUMP into TMP.