[12] For there are some eunuchs, which were so born from [their] mothers womb: and there are some eunuchs, which were made eunuchs of men: and there be eunuchs, which have made themselves eunuchs for the kingdom of heavens sake. He that is able to receive [it], let him receive [it]. The reference to "eunuchs" in Matthew 19:12 has yielded various interpretations. Eunuchs are mentioned many times in the Bible, such as in the Book of Isaiah (56:4) using the word סריס (saris). Although the Ancient Hebrews did not practice castration, eunuchs were common in other cultures featured in the Bible, such as ancient Egypt, Babylonia, the Persian Empire, and ancient Rome. In the Book of Esther, servants of the harem of Ahasuerus, such as Hegai and Shashgaz, as well as other servants such as Hatach, Harbonah, Bigthan, and Teresh, are referred to as sarisim. Being exposed to the consorts of the king, they would likely have been castrated. There is some confusion regarding eunuchs in Old Testament passages, since the Hebrew word for eunuch, saris (סריס), could also refer to other servants and officials who had not been castrated but served in similar capacities.One of the earliest converts to Christianity was an Ethiopian eunuch who was a high court official of Candace, the Queen of Ethiopia, but was already a eunuch at the time of conversion (Acts 8:27–39). Non-castrated eunuchs
The term eunuch has sometimes figuratively been used for a wide range of men who were seen to be physically unable to procreate.
For example, it has been used for hyperuricemia in gout, in other rheumatologic conditions, and in rhabdomyolysis with kidney failure. Contraindication
Rasburicase use is contraindicated in patients with a G6PDH deficiency. Side effects
Rasburicase administration can cause anaphylaxis (incidence unknown); methemoglobinemia may occur in susceptible individuals such as those with G6PDH deficiency due to the production of hydrogen peroxide in the urate oxidase reaction. Testing patients for G6PDH deficiency prior to starting a course of rasburicase has been recommended. Pharmacology
Mechanism of Action
In humans, uric acid is the final step in the catabolic pathway of purines. Rasburicase catalyzes enzymatic oxidation of poorly soluble uric acid into an inactive and more soluble metabolite allantoin with carbon dioxide and hydrogen peroxide as byproducts in the chemical reaction. Pharmacodynamics
The measurement of plasma uric acid was used to evaluate the effectiveness of rasburicase in clinical studies. Following administration of either 0.15 or 0.20 mg/kg rasburicase daily for up to 5 days, plasma uric acid levels decreased within 4 hours and were maintained below 7.5 mg/dL in 98% of adult and 90% of pediatric patients for at least 7 days. There was no evidence of a dose response effect on uric acid control for doses between 0.15 and 0.20 mg/kg rasburicase. Pharmacokinetics
The pharmacokinetics of rasburicase were evaluated in both pediatric and adult patients with leukemia, lymphoma or other hematological malignancies. Rasburicase exposure, as measured by AUC0-24 hr and Cmax, tended to increase with a dose range from 0.15 to 0.2 mg/kg.