biopsies and biochemical measurements indicate increased cellular
and metabolic activity in active Paget's disease. When bone resorption
exceeds bone formation, hypercalciuria and/or hypercalcemia may develop.
The latter is rare and when it occurs, it is usually in an immobilized
patient. In some but not all studies an increased incidence of primary
hyperparathyroidism has been reported. Some studies have associated
the gouty diathesis, which can include hyperuricosuria, uric acid
stones, and even full-blown gout with Paget's disease. This could
be related to increased purine metabolism in bone cells.