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Acute gout attack with normal serum uric acid levels.
Mihaela Bădulescu1, Luana Macovei, Elena Rezuş
1University of Medicine and Pharmacy Grigore T. Popa - Iaşi, Department of Medical Specialties (II).
Summary
Many acute gout attacks occur with normal serum uric acid levels. This suggests that diagnosis should rely on clinical signs and colchicine response, not just uric acid levels.
Area of Science:
- Rheumatology
- Clinical Medicine
Background:
- Gout is a common inflammatory arthritis characterized by hyperuricemia.
- However, acute gout attacks can present with normal serum uric acid levels, posing diagnostic challenges.
Purpose of the Study:
- To determine the prevalence of acute gout attacks presenting with normal serum uric acid levels.
- To evaluate the correlation between normal uric acid levels and inflammatory markers in gout patients.
Main Methods:
- Retrospective study of 30 patients diagnosed with acute gout attack.
- Diagnosis confirmed by clinical manifestations and positive response to colchicine therapy.
- Serum uric acid, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) levels were analyzed.
Main Results:
- A significant proportion (63.3%) of patients with acute gout attacks exhibited normal serum uric acid levels.
- Elevated inflammatory markers were observed, with high ESR in 76.6% and elevated CRP in 30% of patients.
- Increased urinary uric acid excretion was noted in 55% of the 11 patients tested.
Conclusions:
- Acute gout attacks can occur despite normal serum uric acid levels.
- Clinical presentation and response to colchicine are crucial for diagnosis when uric acid levels are normal.
- Normal uric acid levels in acute gout are associated with increased inflammation and uric acid excretion.
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