Hyperuricemia is a classic feature of gout, but nearly half of the time gout occurs without hyperuricemia and most people with raised uric acid levels never develop gout.   Thus, the diagnostic utility of measuring uric acid levels is limited.  Hyperuricemia is defined as a plasma urate level greater than 420 μmol/l ( mg/dl) in males and 360 μmol/l ( mg/dl) in females.  Other blood tests commonly performed are white blood cell count , electrolytes , kidney function and erythrocyte sedimentation rate (ESR). However, both the white blood cells and ESR may be elevated due to gout in the absence of infection.   A white blood cell count as high as ×10 9 /l (40,000/mm 3 ) has been documented. 
Shirley is a 14-month-old girl with rosy cheeks and a dimpled smile. She was born at 24 weeks’ gestation and spent 4 months in the neonatal intensive care unit (NICU) before coming home. At 1 pound 3 ounces, Shirley’s start was a rough one, and she struggled to survive and gain weight. She has Stage 3 ROP in her left eye and Stage 4 ROP in her right eye. Shirley is visually interested in her world and especially enjoys watching her mother’s and grandmother’s faces. Shirley is beginning to reach for high-contrast toys and objects that are nearby. She will visually follow the family’s dog and smile when he approaches her. She recognizes her bottle and will begin to make sucking sounds when she sees it. Shirley picks up finger foods and brings them to her mouth when they are placed on her highchair tray. She is able to roll from front to back and back to front. She rolls towards things that are within three feet of her.