There are several causes of hyperuricaemia:

Drugs: cytotoxics, thiazides & loop diuretics, ethambutol, pyrazinamide, low dose aspirin

Increased cell turnover: Metastatic cancer, multiple myeloma, leukaemia, lymphoma, psoriasis, haemolysis, rhabdomyolysis

Reduced excretion: Chronic renal disease, acidosis, pre-eclampsia

Other: hypertension, hyperlipidaemia, excess alcohol intake

When the metabolism and excretion of uric acid is defective, body fluids may become saturated with urate and crystals are deposited, usually in joint fluid, leading to the symptoms of gout. The most accurate way to diagnose gout is by joint aspiration to identify uric acid crystals in the synovial fluid. Primary or classic gout, is characterised by acute onset of severe pain with peak intensity within the first twelve hours, usually at the base of the first metatarsophalangeal joint. 10% of cases are polyarticular.

A flare can last for up to ten days. Crystals can also precipitate in the renal parenchyma giving rise to gouty nephropathy and renal stones. It is important to note that in gout serum urate levels may be normal during an acute attack and thus the optimal time for measurement is approximately two weeks after a flare resolves.

Please contact us for more information on the reference ranges used at Enfer Medical.