The mackerel was in fact a red herring

A case of misdiagnosis and therapeutic misadventure is presented. The misdiagnosis resulted from the coincidental intake of mackerel and poor history taking. The therapeutic misadventure resulted from treatment with allopurinol and thiazide, which may not have been indicated. Dietary regulations for the treatment of certain biochemical abnormalities may be more desirable than therapeutic interventions. Use of allopurinol for hyperuricemia, if indicated, should be reserved for overproducers and not undersecretors.