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January 9, 1960


JAMA. 1960;172(2):189. doi:10.1001/jama.1960.03020020069020

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To the Editor:—  Regarding Dr. Stanley L. Wallace's query in The Journal, Nov. 7, page 1401, about the occurrence of true hyperuricemia in patients with myocardial infarction, there is ample evidence that this does occur in the absence of azotemia or leukemia. The real question is whether this is a casual coincidence or indicative of true gout. From studies being conducted it appears that myocardial infarction, and essential hypertension as well, may be manifestations of so-called asymptomatic hyperuricemia, and a therapeutic trial with probenecid is warranted. This will require a long-term study with a large number of case reports for final evaluation.It has also been observed that slight elevations of serum uric acid content may occur, perhaps as a stress phenomenon, in patients with diseases unrelated to gout. It is suggested, therefore, that strict criteria be adhered to before the diagnosis of gout is made and specific therapy advised.

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