All of the following conditions are observed in Gout except
Correct Answer: Deficiency of enzyme Xanthine oxidase
Description: About one-third of the body uric acid pool is derived from dietary sources and two-thirds from endogenous purine metabolism . The concentration of uric acid in body fluids depends onthe balance between endogenous synthesis, and elimination by the kidneys (two-thirds) and gut (one-third). Purine nucleotide synthesis and degradation are regulated by a network of enzyme pathways, but xanthine oxidase plays a pivotal role in catalysing the conversion of hypoxanthine to xanthine and xanthine to uric acid. Xanthine oxidase inhibitors are used in treatment of chronic gout . So , Deficiency of this enzyme does not lead to gout . Allopurinol is the drug of first choice. It inhibits xanthine oxidase,which reduces the conversion of hypoxanthine and xanthine to uric acid. Ref Davidsons 23e p1013,1015
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