Catalase deficiency may complicate urate oxidase (rasburicase) therapy.
Patients with low (inherited and acquired) catalase activities who are treated with infusion of uric acid oxidase because they are at risk of tumour lysis syndrome may experience very high concentrations of hydrogen peroxide. They may suffer from methemoglobinaemia and haemolytic anaemia which may be attributed either to deficiency of glucose-6-phosphate dehydrogenase or to other unknown circumstances. Data have not been reported from catalase deficient patients who were treated with uric acid oxidase. It may be hypothesized that their decreased blood catalase could lead to the increased concentration of hydrogen peroxide which may cause haemolysis and formation of methemoglobin. Blood catalase activity should be measured for patients at risk of tumour lysis syndrome prior to uric acid oxidase treatment.
Góth
László
L
Department of Clinical Biochemistry, Molecular Pathology and Clinical Analytical Chemistry, Medical College, Medical and Health Science Center, University of Debrecen, Debrecen, Hungary. goth@dote.hu
Bigler
N William
NW
D020642:Acatalasia / Q000150:complications / Q000175:diagnosis*; D002374:Catalase / Q000097:blood*; D005954:Glucosephosphate Dehydrogenase / Q000032:analysis; D005955:Glucosephosphate Dehydrogenase Deficiency / Q000175:diagnosis; D006461:Hemolysis; D006801:Humans; D006861:Hydrogen Peroxide / Q000032:analysis; D008708:Methemoglobinemia / Q000139:chemically induced / Q000175:diagnosis / Q000209:etiology; D015275:Tumor Lysis Syndrome / Q000150:complications / Q000517:prevention & control*; D014503:Urate Oxidase / Q000009:adverse effects* / Q000627:therapeutic use
C469709:rasburicase; D006861:Hydrogen Peroxide; D005954:Glucosephosphate Dehydrogenase; D002374:Catalase; D014503:Urate Oxidase