Why are gout flares common in hospitalized patients undergoing diuresis but not commonly observed in cancer patients with hyperuricemia resulting from tumor lysis syndrome?  

Tumor lysis syndrome (TLS) occurs with the release of uric acid, potassium, phosphorus and calcium into the bloodstream in response to cytolytic therapy administered in the setting of treatment for acute leukemia, B-cell lymphoma and rarely for solid neoplasms. Kidney injury results from the precipi...

Gout flares likely occur in both clinical scenarios, although far more common with diuretic use. There are several potential reasons: (1) underexcretion of urate is a far greater contributor to body urate load than overproduction; (2) chronic kidney disease is far more common in the former than latt...