Which of the following is a symptom of Lesch-Nyhan syndrome related to increased uric acid?

Lesch-Nyhan syndrome is a genetic disorder caused by a deficiency of hypoxanthine-guanine phosphoribosyltransferase (HGPRT), which is essential for purine metabolism. This deficiency leads to the overproduction of uric acid, resulting in hyperuricemia. One of the hallmark clinical features of this syndrome is the development of severe gouty arthritis, which occurs due to the accumulation of uric acid crystals in the joints.

Patients with Lesch-Nyhan syndrome often experience recurrent episodes of gout, characterized by inflammation, pain, and swelling in the affected joints. The increased levels of uric acid can lead to the formation of tophi, which are deposits of monosodium urate crystals that can be palpated in chronic cases. Thus, the severe gouty arthritis is a direct manifestation of the underlying metabolic derangement associated with the syndrome.

The other options—bone marrow suppression, hemolytic anemia, and diabetes mellitus—are not characteristic symptoms of Lesch-Nyhan syndrome. Bone marrow suppression and hemolytic anemia are more commonly associated with other disorders, while diabetes mellitus is unrelated to the purine metabolism issues seen in Lesch-Nyhan syndrome. Therefore, the presence of severe