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Pathophysiology of Gout


  • humans lack the enzyme uricase which is involved in elimination of excess nucleic acid purines & nitrogenous waste products through production and excretion of allantoic acid;
    • hence in humans, uric acid is end product of purines degradation;
  • gouty arthritis begins w/ deposition of MSU crystals in synovial & periarticular tissue;
  • factors related to microtophus formation:
    • reduced solubility of MSU at the periphery of the body because of lower temperatures;
    • weight bearing (MTP joint incurs high force / area)