DAVID KAPLAN, M.D.; DAVID BERNSTEIN, M.D.; STANLEY L. WALLACE, M.D., F.A.C.P.; DAVID HALBERSTAM, M.S.
There are potentially two main causes of the hyperuricemia in gout—underexcretion of uric acid and overproduction of uric acid. Underexcretion can occur either in the gastrointestinal tract or in the kidney. Sorensen (1) has shown that uric acid destruction by bacterial flora of the gastrointestinal tract is not decreased and may even be increased in gouty subjects. Underexcretion of uric acid in the kidney, however, has been demonstrated in some gouty individuals (2, 3). These patients had decreased clearance of endogenous uric acid when all other parameters of renal function were normal. Inability of the gouty patient to excrete normal
KAPLAN D, BERNSTEIN D, WALLACE SL, HALBERSTAM D. Serum and Urinary Amino Acids in Normouricemic and Hyperuricemic Subjects. Ann Intern Med. ;62:658–666. doi: 10.7326/0003-4819-62-4-658
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Published: Ann Intern Med. 1965;62(4):658-666.
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