SERUM URATE IN RELATIVES OF GOUTY PATIENTS 1 2

Though the hereditary nature of gouty arthritis has been recognized for centuries, systematic studies of afflicted families are rare. Of several items which are pertinent to such studies, there are at least two significant ones. These concern (a) the hereditary transmission of gout and (b) the pathogenesis of its clinical manifestations. If the hereditary data are obtained from routine clinical records without painstaking study of the living relatives, the familial incidence appears to be low. Diligent medical and social investigation of gouty families, however, discloses evidence which indicates a high familial incidence and sup-ports the hypothesis that gout is an hereditary malady (1, 2, 3, 4, 5). Such a survey which has been conducted by us has shown, in addition, that an elevated serum urate may be observed in rela-tives of gouty patients even though they, the rela-tives, display no other clinical evidence of gout or gouty arthritis. EXPERIMENTAL OBSERVATIONS These data were obtained during the past five years from the investigation of one hundred and thirty-six blood relatives of twenty-seven patients with gout. A clinical diagnosis of gout (6, 7) was apparent in each of the patients. Twenty-three of the twenty-five males had x-ray evidence of gouty arthritis. The two females had proved urate tophi. The concentration of serum urate (8) was determined four or more times. In all except one sample from one patient it was greater than 6.0 mgm. per 100 cc. In the absence of renal insufficiency or leukemia, an elevation of serum urate above 6.0 mgm. constitutes important evidence in support of a diagnosis of gouty ar-thritis in patients with unexplained joint disease. 1This investigation was aided by a grant from th