Menace of hyperuricemia
Excruciating pain in ankles.hallux and any other site is commonest presentation of hyperuricemia.
It has been seen to present in my experience as
1.a 36yr old lady had uric  acid of only 5.6 and her problem of pain in legs.knees and then generalised further aggravated and after 2 to 3 mnths facial edema and pedal edema appeared .she didnt get relief on any rx by various doctors and at last consulted me.i opined in her case uric acid shld be normally below4 insted of 7 and thus febuxostat was instituted .for 10 days her edema and pain didnt respond but patiently it was advised to continue.after 2 wks some relief was felt and thus same rx was continued for more than  1mnth till she became asymptomatic and her uric acid brought below 4 which I feel should be considered upper  normal in such patients.
2.in my 8 yr old son uric acid was just 4.9 but he had such excriciating sole pain that he barely walked.he was too treated in same way to reduce its level below 3.5.
3.a young poor lady had severe intolerable giddiness and straight away slept in  my clinic even on floor as she couldnt balance to sit even.all sorts of rx for vertigo was tried but none worked.at last uric acid was found 6.9 and its rx continously for 10 days reduced giddiness by 25% and thus same rx for 1 1/2  mnth completely subsided the symptoms and thus she became normal.she has taken several rx for it by at least 7 doctors before she consulted me.
thanks
dr s kumar.

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