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May 23, 1977

Gout and Hyperuricemia

JAMA. 1977;237(21):2336. doi:10.1001/jama.1977.03270480076031

Drs Wyngaarden and Kelley are among the foremost scholars of urate metabolism, and this book reflects their experience and wisdom. Although the two authors are of different temperaments and personality, the writing blends so well that I was unable to assign given sections to either individual. Thus, the book would seem to represent a truly close collaborative effort.

The authors have a strong research interest in purine metabolism, and those sections of the book flow easily and are readily comprehended. The methodology of various metabolic studies was covered in principle, and the limits of interpretation of data derived from specific experiments was carefully presented. With all the research to date, we still do not have much understanding of the heterogenous disorders we recognize as hyperuricemia and clinical gout.

There is an excellent discussion of renal mechanisms of urate excretion in gouty subjects. About 75% to 90% of patients show diminished