Pathogenesis of Hyperuricemia in Saturnine Gout

Thirty-seven of 43 admissions for gout to the Birmingham Veterans Administration Hospital in 1967 were for gout of the "saturnine" variety secondary to prolonged consumption of moonshine contaminated with lead. Uric acid kinetic studies done on three typical patients on a purine deprivation diet yielded similar results. Mean values were: uric acid turnover, 550 mg per day; uric acid pool, 1308 mg per day; urinary uric acid in percentage of turnover, 25.7; and uric acid recovered from urine for seven days, as percentage of dose, 24.9. Glycine-14C incorporation into urinary uric acid expressed as percentage of dose and corrected for extrarenal disposal was 0.102. These results confirm the role of the kidney in the pathogenesis of hyperuricemia in this disorder and the susceptibility of these patients to the development of gout.