Hyperuricosuria due to high-dose pancreatic extract therapy in cystic fibrosis.

Dysuria, uric acid crystalluria and hyperuricosuria developed in a child with cystic 
fibrosis and normal serum uric acid. Hyperuricosuria in this patient and 
two other children was directly related to ingestion of large amounts 
of pancreatic extract. In these three children, reducing pancreatic extract dosage 
by 85 percent lowered their purine intake by 307, 225, and 
148 mg, respectively; urinary uric acid excretion decreased by 245, 239, 
and 158 mg. Overmedication resulted from parents' decisions to increase enzyme 
dosages. In our cystic fibrosis clinic, 15 of 32 patients screened 
at random were taking higher than the prescribed dose of pancreatic 
enzymes, and 14 of these 15 children were hyperuricosuric. On the 
basis of this information, we suggest that the minimal effective dose 
of pancreatic extract should be determined and adhered to for each 
child with cystic fibrosis to avoid potential renal injury from hyperuricosuria. 
