Objectives As all other crystal-related arthropathies, uric gout (UG) is a disease that is relatively disabling in its acute phase. There is a lack of published works on the characterisation and prevalence in the portuguese population. The authors’ have initiated a study on the sociodemographic and clinical characterisation of the patients with UG of their outpatients rheumatology clinic.
Methods It is a retrospective study, whose data collection took place between May and October 2000, and was later restarted in December 2000. The sample included all patients which presented a UG diagnosis. A 48 variable questionnaire and the patient’s clinic register were used for the gathering of data. The questionnaire comprised the patient’s identification, professional occupation, clinical profile, changes in the laboratorial and radiological exams, associated diseases, habits, family history. The data analysis was performed using the SPSS 9.0 for Windows software.
Results Of an outpatient’s clinic universe of 3000 patients, a total of 39 (1.9%) patients with UG diagnosis was selected. Only 32 of these, were included in the study, representing the sample. It is characterised by an average age of 59.4 and 87.5% males. The average age at which the first UG crisis happens is 45. The average duration of crisis without therapeutics is 13.7 days, and with therapeutic is 5.4 days. The average asymptomatic period is variable, with a minimum of 15 days and a maximum of 100 days. In 51.6% of the patients the first affected joint is the 1st MTP, followed by the instep, knee and ankle. Globally, the most affected joints are, in decreasing order, 1st MTP and foot, knee, ankle, hand and fingers, elbow, wrist and shoulder. About 33% of the sample patients show gouty tophi. The precipitating factors can only be identified by 78% of the patients, and they are, in decreasing order, alcohol + meals, meals, other disease or trauma, alcohol, and cold. The average of the serum uric acid measured at the first appointment is 9.7 mg/dl. The urine uric acid was measured in 50% of the patients, presenting an average value of 670 mg/24 h. The average serum creatinine is 1.7 mg/dl, in which 5 patients had renal impairment. Only 28.1% of the sample was researched for crystals in sinovial fluid, being positive in 11.1% of these. X-rays were performed on 53.1% of the patients, and among these 88.2% present radiological abnormalities. In what concerns associated diseases, 60% were obese, having also been considered the following diseases: diabetes, hypertension and hyperlipidemia. Additionally, 35.5% of the patients have moderate to heavy alcoholic habits, 42.6% have family history of UG.
Conclusion The results obtained in this study are in good agreement with the published literature concerning the european and north-american population. The sample considered is small due to the fact that this study was paused, and restarted latter, now tuned into the research of monosodium urate monohydrate crystals to confirm the clinical diagnosis.
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