Along with other pathologies, a violation of purine metabolism is also considered a serious disease, the treatment of which should be given attention. First of all, it is a malfunction in the metabolism of beneficial substances that provoke the occurrence of other diseases, such as gout, nephropathy or renal failure.
As a rule, there is a violation of purine metabolism in children, but adults are also susceptible to this pathology. Only usually patients in adulthood face a number of concomitant diseases and complications.
General information
Violation of purine metabolism according to ICD-10 has the code E79. Usually this disease has a chronic nature and is directly related to the deposition of acid salts in the tissues of the kidneys and joints. Symptoms of purine metabolism disorders are quite specific and appear as repeated exacerbations of arthritis, accompanied by pain.
An undetected and untreated on time problem can lead to more serious consequences: for example, the onset of urolithiasis and renal failure. All therapeutic measures in this situation are usually aimed at stopping unpleasant symptoms, reducing the severity of the clinical picture, preventing the development of complications and normalizing the metabolism of beneficial substances.
Causes of pathology
A prerequisite for the development of the disease is the excessive formation of purine bases or their too slow excretion with uric acid.
The primary form of pathology is explained by a hereditary predisposition. But the secondary type of the disease can be associated with the regular use of diuretics, anti-inflammatory drugs and other medications.
Violations of purine metabolism provoke:
- alcohol;
- severe hypothermia;
- some pharmaceuticals;
- products containing appropriate formulations;
- pathology of an infectious nature;
- psychoemotional and physical overstrain.
Symptoms
Signs of impaired purine metabolism resemble typical manifestations of metabolic failure. Pathology is characterized by an increased level of creatinine kinase, which appears in almost all patients. Other non-specific signs of the disease can be detected by electromyographic examination.
In patients with impaired purine metabolism, extremely low ammonia production is observed, due to which working capacity is significantly reduced and appetite is almost completely absent. Patients feel general malaise, lethargy, depression. In some cases, pronounced weakness develops.
Children who suffer from purine metabolism disorders for a long time often remain psychologically underdeveloped and have an increased tendency to autism. In more rare cases, in small and adult patients, seizures resembling epileptic and seizures occur. In addition, the psychomotor development of a sick person slows down or stops altogether.
Features
The most striking disorders of purine metabolism include the excessive formation and further accumulation of uric acid, which is observed with gout and Lesch-Nyhan syndrome. The latter lies in the hereditary lack of a specific enzyme, which leads to the non-use of re-released purines. As a result, they are oxidized, converting to uric acid.
Diagnostics
The detection of the disease is extremely difficult and does not always give an accurate result, since this pathology has many signs similar to other disorders in homeostasis. However, with prolonged monitoring of the patient's condition and its analyzes in general, it is quite possible to detect malfunctions in the purine metabolism and the reasons for its appearance.
The diagnosis can be made on the basis, first of all, of a complete lack of indicators of the functioning of renal enzymes, active substances of the liver and skeletal muscles. With laboratory tests, partial failure can be detected in lymphocytes and fibroblasts.
Special treatment, which would be aimed at eliminating enzyme dysfunction, has not yet been developed, so you can only rely on complex therapy.
Treatment
Purine metabolism disorders require complex treatment, which is based primarily on a strict diet, including products with a low content of uric acid, and drug therapy.
Pharmacological methods include several stages:
- balance and normalization of metabolic processes with the help of fortification;
- establishment of metabolic acidosis and control of the acidic environment in urine;
- the establishment and constant maintenance of a normal level of hyperlipidemia;
- monitoring and normalization of the patient's blood pressure during the day;
- therapy of probable complications of pathology.
Treatment of the consequences
Gout - a violation of purine metabolism, which was not diagnosed and treated in time. These diseases are very closely related. That is why the signs and treatment of gout are not much different from those with metabolic failures. In general, the treatment of this pathology comes down to the correction of purine metabolism. For this, the patient is recommended:
- limit physical activity at the time of exacerbations;
- following a certain diet;
- drinking regime, including 2 liters of water daily;
- use of local compresses using Dimexidum;
- the use of prescribed doses of non-steroidal anti-inflammatory drugs.
Treatment of purine metabolism disorders can be carried out both in stationary conditions and at home. However, the latter option is valid only after consulting a specialist and confirming the diagnosis.
Drug therapy
Basic treatment is based on prolonged use of drugs that normalize the amount of uric acid in the blood. You can use medicines only during the period of remission. Depending on the impact, there are several varieties of recommended drugs:
- agents that reduce the production of uric acid, for example, Allopurinol;
- medicines containing etebenecid - increase the rate of excretion of uric acid from the body;
- mixed-action drugs.
Long-term drug therapy is advisable for frequent attacks, a pronounced clinical picture of the disease, the formation of tofus and injury to the kidneys.
During periods of remission, patients are also shown a variety of physiotherapeutic procedures: massage, paraffin baths, ultrasound.
Diet for violation of purine metabolism
In almost all treatment schemes for pathology, doctors mention compliance with a certain diet. A special diet helps the patient effectively eliminate the negative effects of metabolic disorders. Usually, the role of the first complications with which a balanced diet effectively copes is the disorder in fat metabolism. Against the background of this pathology, the patient is rapidly gaining mass, and sometimes is faced with atherosclerosis, coronary heart disease, as well as a steady increase in blood pressure.
In all the situations described, specialists prescribe to patients diets in which the quantity or products rich in purines is limited or completely absent. These include: mushrooms, meat, legumes, fish. In addition, patients are shown fasting days with a vegetable, dairy or fruit menu.
It is worth saying that a diet for violations of purine metabolism should be used for quite a long time. The patient's diet provides for fractional nutrition 4-5 times a day.
The menu excludes foods containing oxalic acid and purines, and has certain limitations regarding salt, protein, fat, and carbohydrates. The energy value of the daily diet should range from 2700-2800 calories. The daily menu provides for the consumption of 80 g of protein, 90 g of fat, 400 g of carbohydrates.
Recommended Products:
- low-fat varieties of meat and fish;
- dairy components;
- bread from the first grade of flour;
- all kinds of cereals;
- vegetables and fruits in any form.
The following should be excluded:
- fatty types of fish and meat;
- raspberries;
- strong tea and coffee;
- chocolate;
- cocoa powder;
- legumes;
- cranberries;
- sorrel.
A variety of cooking oils are also prohibited.
If you follow a properly selected diet and other components of complex treatment, the patient feels significant relief in just a few weeks.