Question:
Which of the following is the underlying metabolic basis of acute gout?
Which of the following is the underlying metabolic basis of acute gout?
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Think which biochemical change actually drives crystal deposition; xanthine oxidase makes urate, it does not remove it.
Updated On: Jun 23, 2026
- Uric acid nephrolithiasis
- Deficiency of enzyme xanthine oxidase
- Increase in serum urate concentration
- Renal disease involving interstitial tissues
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The Correct Option is C
Solution and Explanation
Step 1: Gout is a disorder of purine metabolism in which serum uric acid rises because of overproduction or under-excretion of urate. The central biochemical event that drives an acute attack is sustained hyperuricaemia, that is an increase in serum urate concentration above its solubility limit. Step 2: When the serum urate is supersaturated, monosodium urate crystals deposit in the joint and trigger a neutrophil-driven inflammatory response, producing the classic acute gouty arthritis. So an increase in serum urate concentration (option c) is the metabolic driver. Step 3: Xanthine oxidase actually converts hypoxanthine to xanthine and xanthine to uric acid; its activity tends to be normal or high in gout, and its deficiency would LOWER uric acid, so option b is biochemically incorrect for gout pathogenesis. Step 4: Uric acid nephrolithiasis (option a) and interstitial renal disease (option d) are complications or contributing factors, not the core metabolic mechanism. Note: The recall answer key marked option b; that is medically incorrect because xanthine-oxidase deficiency reduces urate. The correct metabolic basis of gout is raised serum urate (option c).
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