Does G6PD Deficiency Cause Gout? Mechanism?

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theWUbear

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My professor has written G6PD deficiency, but neglected von Gierke's disease (G6P deficiency) in a list of causes of hyperuricemia. This leaves me with one of two conclusions: he missed von Gierke, or he made a mistake and wrote G6PD deficiency instead of G6P deficiency.

Uptodate on G6PD deficiency does not mention gout.

Varous USMLE forums present more questions than answers but I am having difficulty finding a reputable source.

Is G6PD deficiency a cause of gout? What is the mechanism involved?

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Typo, obviously meant G6Pase.

Send an e-mail to confirm if you're still worried.
 
Hyperuricemia can be acute or chronic. Gout is a little different than hyperuricemia; long-standing hyperuricemia causes gout. Von Gierke's may cause gout, because the hyperuricemia is chronic as is the disease (hyperuricemia results from chronic lactic acidosis and the uric acid competes for excretion in the kidney). G6PD is episodic-- therefore the hyperuricemia is episodic. And should not cause gout.

This is not based on anything I have read, but rather by my own thinking of the nature of gout versus simple hyperuricemia and the disease mechanisms behind G6PD deficiency and G6P deficiency.

I hope that is accurate (and helpful).
 
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Pretty sure he meant G6PD = G6P deficiency. Seems plausible that chronic hemolysis (in G6PD deficiency) could lead to hyperuricemia, which would then obviously increase the risk for gout, but that's not a common association I've heard of.
 
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Pretty sure he meant G6PD = G6P deficiency. Seems plausible that chronic hemolysis (in G6PD deficiency) could lead to hyperuricemia, which would then obviously increase the risk for gout, but that's not a common association I've heard of.

Glad I don't need to know this anymore.
 
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G6Pase is definitely correct. As for G6PD deficiency, it is needed for NADPH production in pentose phosphate pathway and NADPH is needed for oxidative stress in RBCs. So let's say you have G6PD deficiency and eat something like a fava beans. The NADPH cannot handle the oxidative stress in the RBCs and you end up with hemolytic anemia. Hyperuricemia is seen in hemolytic anemia (high purine turnover). Now you can't conclude that it will lead to gout because not all hyperuricemia leads to gout, but you can say that G6PD deficiency can lead to hyperuricemia
 
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