{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T09:03:06Z","timestamp":1781168586004,"version":"3.54.1"},"reference-count":60,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>During acute gout flares, serum uric acid (SUA) levels may remain within the normal range, making diagnosis based solely on SUA unreliable. A systematic evaluation incorporating clinical symptoms and imaging (ultrasound, dual-source CT) is essential to detect monosodium urate (MSU) crystal deposition. Normal-SUA gout often presents with more pronounced inflammation, fever, elevated white blood cell count and C-reactive protein, and may occur after surgery or hemodialysis. Tophi can appear at typical or atypical sites (e.g., face, neck). No specific treatment guidelines exist, but lowering SUA to &amp;lt;360 \u03bcmol\/L (6 mg\/dl) reduces gout flares and promotes MSU dissolution. Emerging therapies\u2014including anti-IL-1\u03b2 monoclonal antibodies, NLRP3 inhibitors, uricases, and green tea components\u2014show promise in controlling attacks and dissolving crystals without affecting SUA levels.<\/jats:p>","DOI":"10.3389\/fendo.2026.1873856","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T08:54:51Z","timestamp":1781168091000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Normal serum uric acid gout: a neglected and challenging condition"],"prefix":"10.3389","volume":"17","author":[{"given":"Xiu Hong","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Nephrology, Huadong Hospital, Fudan University","place":["Shanghai, China"]},{"name":"Shanghai Key Laboratory of Clinical Geriatric Medicine, Huadong Hospital, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao 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