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Gouty tophi without hyperuricemia, an interesting case diag..:

Debashish Bhattacharjee ; Santosh K Mondal ; Rudra Narayan Ray.
http://www.err.eg.net/article.asp?issn=1110-161X;year=2017;volume=44;issue=3;spage=139;epage=141;aulast=Bhattacharjee.  , 2017
Link: https://doi.org/10.4103/1110-161X.212041