![Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F61682.jpg&w=3840&q=50)
Normal serum uric acid gout: a neglected and challenging condition
Xiu Hong Yang1,2, Xiao Li Zhan3, Qing Xia Xuan4
1Department of Nephrology, Huadong Hospital, Fudan University, Shanghai, China.
Frontiers in Endocrinology
|June 29, 2026
Summary
Diagnosis of gout flares can be challenging when serum uric acid (SUA) levels are normal. A comprehensive approach using clinical signs and imaging is vital for detecting monosodium urate (MSU) crystals.
Area of Science:
- Rheumatology
- Biochemistry
Background:
- Serum uric acid (SUA) levels can be normal during acute gout flares, complicating diagnosis.
- Monosodium urate (MSU) crystal deposition is the hallmark of gout, but its detection is challenging with normal SUA.
Purpose of the Study:
- To highlight the diagnostic challenges of gout with normal SUA levels.
- To emphasize the importance of a systematic diagnostic approach beyond SUA measurement.
- To discuss emerging therapeutic strategies for gout management.
Main Methods:
- Systematic evaluation incorporating clinical symptoms.
- Diagnostic imaging techniques such as ultrasound and dual-source CT.
- Review of clinical presentation and treatment outcomes in normal-SUA gout cases.
Main Results:
- Normal-SUA gout may present with increased inflammation, fever, and elevated inflammatory markers.
- Tophi can manifest in both typical and atypical locations.
- Lowering SUA to <360 μmol/L aids in reducing flares and MSU dissolution.
Conclusions:
- Diagnosis of gout requires a comprehensive assessment beyond SUA levels, including clinical and imaging data.
- Normal-SUA gout exhibits distinct inflammatory characteristics.
- Novel therapies targeting inflammation and crystal dissolution show promise for gout management.
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