Gout is a disease characterized by hyperuricemia from an overproduction of
purine nucleotides via the de novo pathway. The specific cause of Lesch-Nyhan
syndrome is a severe deficiency of HGPRTase. Allopurinol is used in the
treatment of gout to reduce the production of uric acid. In Lesch-Nyhan
syndrome, the decrease in uric acid is balanced by an increase in xanthine
plus hypoxanthine in blood. In the other forms of gout, the decrease in uric
acid is greater than the increase in xanthine plus hypoxanthine.
The explanation for this difference in the two forms of gout is
A. it is an experimental artifact and the decrease in uric acid and increase
in xanthine plus hypoxanthine in non-Lesch-Nyhan gout is the same.
B. allopurinol is less effective in non-Lesch-Nyhan gout.
C. there is an increased excretion of xanthine and hypoxanthine in non-Lesch-
Nyhan gout.
D. PRPP levels are reduced in Lesch-Nyhan.
E. in non-Lesch-Nyhan gout hypoxanthine and xanthine are salvaged to IMP and
XMP and inhibit PRPP amidotransferase.