Related Experiment Videos
Gout in black South Africans: a clinical and genetic study
B Cassim1, G M Mody, V K Deenadayalu
1Department of Medicine, University of Natal, Congella, South Africa.
Insights
Gout is more prevalent in black South Africans than previously thought, often affecting multiple joints. An increased frequency of HLA-B14 was observed in primary gout patients.
Area of Science:
- Rheumatology
- Genetics
- Epidemiology
Background:
- Gout is a common inflammatory arthritis.
- Understanding its clinical presentation and genetic factors in diverse populations is crucial.
Purpose of the Study:
- To define the clinical characteristics of gout in black South Africans.
- To investigate potential genetic associations, specifically with HLA antigens, in this population.
Main Methods:
- Retrospective analysis of 107 gout patient records over five years.
- Prospective survey of HLA class I and II antigens in 46 patients.
Main Results:
- Gout presented predominantly in males (6.6:1 ratio).
- Commonly affected joints included the knee (85%), first metatarsophalangeal (74.8%), and ankle (61.7%).
- An increased frequency of HLA-B14 was noted in primary gout patients compared to controls.
Conclusions:
- Gout is more common in black Africans than previously recognized.
- The condition frequently presents with polyarticular involvement.
- The clinical significance of the observed HLA-B14 association requires further investigation.
Objective:
To define the clinical characteristics of gout and determine if there were any genetic associations with gout in black South Africans.
Methods:
The records of 107 patients with gout seen over a five year period were retrospectively analysed. The HLA class I and class II antigens were studied in a prospective survey of 46 patients.
Results:
The male to female ratio was 6.6:1. The diagnosis of gout was based on identification of monosodium urate crystals from the synovial fluid, synovial tissue or tophaceous material in 62 patients (58%) and on clinical criteria in the remaining 45 patients (42%). The mode of presentation was monoarthritis in 40 patients (37.4%), pauciarthritis in 30 (28%) and polyarthritis in 37 (34.6%). The joints which were most frequently involved were the knee in 91 patients (85%), the first metatarsophalangeal in 80 (74.8%) and the ankle in 66 (61.7%). A secondary cause was identified in 52 patients (48.6%) (diuretic therapy in 48 patients and chronic renal impairment in four); 55 patients (51.4%) had primary gout. The genetic study showed an increased frequency of HLA-B14 in patients with primary gout compared with controls.
Conclusions:
Gout is more common in black Africans than previously recognised and frequently presents with involvement of more than one joint. There was an increased frequency of HLA-B14 in patients with primary gout but the clinical significance of this is uncertain.