Frequency of Hyperuricaemic Uveitis in patients taking Antituberculus Therapy in Bahawal Victoria Hospital Bahawalpur

Objective: To determine the frequency of hyperuricaemic uveitis in tuberculous patients taking antituberculus therapy ATT at Bahawal Victoria Hospital Bahawalpur. Duration of Study: The study was conducted in Pulmonology department, Bahawal Victoria Hospital and Ophthalamology Department, in collaboration with Pathology department, Quaid-e-Azam Medical College Bahawalpur from May 2008 to January 2010. Study Design: Observational study. Materials and Methods: 850 patients (750 males and 100 female aged 20 - 60 years) recieving 4 standard drugs as ATT (Rifampicin, PZA, Ethambutol, and isoniazid) were included. We used approved and fixed dose combination of 4 drugs of proven bio equivalence.Serum Uric acid levels and serum creatinine at 8 - 12 weeks after commencement of ATT were measured . Serum Uric acid and creatinine specimens were done on fully automated chemistry analyzer SELECTRA - E (Merck Diagnostics) using Merck reagents. All the patients were examined by slit lamp examination to diagnose uveitis by an ophthalamologist. Results: All study subjects had hyperuricemia and normal creatinine. Keratic precipitates and posterior synechae were found in few percent of the patients. Band keratopathy with refractile, yellow crystals in the deep corneal epithelial cells and at the level of Bowman membrane were seen in one patient.Conjunctival nodules containing needle like crystals were also seen within the intrapalpaberal areas, associated with a mild marginal keratitis in one patient. Conclusion: Hyperuricaemic uveitis starts almost after 8 weeks of commencement of ATT in tuberculous patients. If it is left undiagnosed sight –threatening effects can occur