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Hypouricemia in the hypereosinophilic syndrome. Response to treatment.

HYPOURICEMIA is generally a result of impaired handling of uric acid by the renal tubule. It has been reported in Wilson's disease, heavy metal poisoning, and occasionally in malignant neoplasms. The latter inelude Hodgkin's disease, lung carcinoma, multiple myeloma, and acute myeloid leukemia. 1-3 We recently encountered a patient with severe hypouricemia associated with the hypereosinophilic syndrome (HES). Report of a Case A 60-year-old man was hospitalized after three weeks of high temperatures, night sweats, progressive weakness, and weight loss. The patient denied having any personal or family history of atopy. On admission, he appeared pale and cachectic, the temperature was 38 °C, the pulse rate was 90 beats per minute and irregular, and the BP was 100/60 mm Hg. The relevant physical findings included an apical midsystolic murmur (grade 2/6), hepatosplenomegaly, and generalized lymphadenopathy. A chest roentgenogram was normal. An ECG showed atrial fibrillation. An echocardiogram disclosed an