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Systemic Urate Deposition: An Unrecognized Complication of Gout?
Puja Khanna1, Richard J Johnson2, Bradley Marder3
1Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, MI 48109, USA.
Journal of Clinical Medicine
|October 7, 2020
Summary
Gout urate crystals can deposit in many body parts beyond joints, not just in recurrent cases. Treating gout effectively may reduce these widespread deposits and associated health risks.
Area of Science:
- Rheumatology
- Cardiovascular Medicine
- Nephrology
Background:
- Gout affects over nine million people in the US, with increasing prevalence.
- Current guidelines sometimes delay treatment for non-recurrent gout.
- Urate deposits (tophi) are known in joints, but extra-articular deposition is increasingly recognized.
Purpose of the Study:
- To review literature on extra-articular urate deposition in gout.
- To understand potential risks associated with untreated gout and systemic urate deposition.
- To emphasize the importance of adhering to treatment guidelines for gout management.
Main Methods:
- Literature review of studies documenting extra-articular urate deposition.
- Inclusion of data from autopsy, histopathology, surgery, and radiology.
- Focus on deposition in the heart, vasculature, kidney, spine, eye, skin, and gastrointestinal system.
Main Results:
- Urate deposits are not uncommon in tissues beyond joints, including the vasculature.
- Dual-energy computed tomography (DECT) aids in recognizing these extra-articular deposits.
- Untreated gout may lead to systemic urate deposition with potential health consequences.
Conclusions:
- Gout's impact extends beyond rheumatology, affecting multiple organ systems.
- Physicians should follow American College of Rheumatology guidelines to achieve serum urate levels below 6 mg/dl.
- Further research is needed to determine the clinical impact of systemic urate deposition and potential survival benefits from reducing cardiac and vascular deposits.
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