Uric acid crystal-induced nephropathy: evidence for a specific renal lesion in a gouty family.

Gout is principally a disease of middle-aged men. There has been a lot of discussion over the cause of the renal lesion, whether it is age, hypertension or crystal induced, as single factors or in combination. We have recently been able to study renal biopsies from three related young women with an hereditary gout, and another girl with 2,8-dihydroxyadenine crystal nephropathy. All were normotensive. These findings were compared with the findings of a crystal-induced nephropathy in pigs. In the renal biopsies many stages of acute and chronic nephritis were found which were similar to the crystal nephropathy in pigs. We concluded that the cause of the original lesion in the women was crystal deposition in the tubules, that crystals were not necessary to keep a non-specific nephritis active and that age and hypertension need not be contributory factors.