Gout in South African blacks

A retrospective study was carried out to determine the frequency, age of onset, mode of presentation, pattern of joint involvement, and incidence of primary and secondary gout in black patients with gout who were admitted to the King Edward VIII Hospital in Durban, South Africa. Nineteen patients were admitted to hospital with gout over a 5-year period from 1977 to 1981. The admission rate was found to be 4.7/100 000 hospital admissions. Five patients (26%) presented with monoarthritis and 14 patients (74%) had polyarthritis on admission. The joints most frequently involved were the knees (74%), the first metatarsophalangeal (MTP) joint (58%), and ankles (42%). The serum uric acid (SUA) was increased in 94%, and tophi were noted clinically in 47%. Eight patients (42%) with hypertension were on treatment with diuretics and 7 of these patients had a raised blood urea. These 8 patients (42%) were considered to have secondary gout, while no secondary causes were noted in the remaining 11 patients (58%) who had primary gout.