Treatment of Hyperuricemia

Abstract

To the Editor.— I appreciated the comments made by John H. Talbott, MD, on psoriasis-associated gouty hyperuricemia (242:1193-1197, 1979). Aside from what appears to be a typographical error in the probenecid dosage (0.5 g, rather than the stated 0.5 mg), the rate of urinary uric acid excretion may provide further information useful to the selection of an appropriate agent. Twenty-four hour rates of greater than 600 mg may predispose these patients to increased risk for renal urolithiasis when receiving therapy with uricosuric agents. 1 Patients with gout may have an eightfold risk increase for stone development when compared with normal subjects. 2 Mild intermittent skin conditions may compare favorably with the joys of renal colic. In such a setting, therapy with allopurinol may be a desirable option. If the patient is a hypoexcretor of urinary uric acid, and skin reactions continue to be a problem, treatment with sulfinpyrazone, begun at