Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Despite the well known risk of hyperuricaemia in Sickle Cell Disease (SCD), it has not been determined if these patients are more prone to gout than the general populace. We studied the frequencies of gout between patients with SCD and controls with haemoglobin AA genotype and determined the factors associated with gout in SCD.
Methods: A prospective study of 104 patients with haemoglobin SS or SC and 104 age and sex-matched control participants with haemoglobin AA was conducted at the University of Ilorin Teaching Hospital, Nigeria. Clinical and demographic information were obtained from each participant and 10 ml of venous blood was taken for determination of haemoglobin genotype, serum uric acid and creatinine. Joint aspiration was done in all individuals presenting with articular pain and swelling. This sample was examined by polarized microscopy for monosodium urate crystals.
Results: The mean age of the patients was 27.4±8.3 years. Eight (7.7%) of the patients had genotype SC while the remaining 96 (92.3%) had SS. Hyperuricaemia was found in 28 (26.9%) and 2 (1.9%) individuals with SCD and controls respectively (p0.001). Six (5.8%) cases of gout were found among the SCD patients and none among the controls (p=0.029). None of the gouty individuals had ever been diagnosed with gout before and they all had serum uric acid in the hyperuricaemic range. Four (66.7%) of them were males giving a male-female ratio of 2:1. The pattern of articular involvement was monoarticular in 2 (33.3%), oligoarticular in 3 (50%) and polyarticular in 1 (16.7%). The knee was the most frequently affected joint seen in 4 patients. Five (66.7%) individuals reported having had painful and swollen joints on more than two occasions in the past while only one (16.7%) reported a single previous episode. One (16.7%) patient had subcutaneous tophi. Factors associated with gout in SCD were age, hyperuricaemia, more than two SCD crises in the past year and more than two hospital admissions in the past year (p 0.05 in each case).
Conclusion: Gout is more frequent in SCD than in individuals with HbAA genotype and many episodes of gouty attacks may have been mistaken for vaso-occlusive crises thereby delaying correct diagnosis and leading to mounting morbidities.
Characteristics of the patients with gout
|
Age (years) |
Sex |
Genotype |
SUA (µmol/L) |
BMI (Kg/m2) |
Joints involved |
Presence of tophi |
|
|
1 |
52 |
F |
SS |
435 |
23.31 |
Ankles |
Yes |
|
2 |
41 |
M |
SS |
480 |
17.51 |
Lt. knee, Rt. MTP1 |
No |
|
3 |
37 |
M |
SS |
702 |
19.84 |
Rt. ankle |
No |
|
4 |
41 |
M |
SS |
510 |
20.20 |
Knees, Rt elbow, ankles |
No |
|
5 |
44 |
F |
SS |
460 |
18.87 |
Rt. Ankle, Lt. knee, Lt. MTP1 |
No |
|
6 |
35 |
M |
SC |
440 |
24.06 |
Lt. Knee |
No |
SUA=Serum Uric Acid; BMI=Body Mass Index; Lt.=Left; Rt.=Right; MTP1=1st metatarsophalangeal joints
Factors associated with gout among patients with SCD
|
Patients with gout N=6 (%) |
Patients without gout N=98 (%) |
P-value |
|
|
Genotype |
|||
|
SS |
5 (83.3) |
91 (92.8) |
0.389 |
|
SC |
1 (16.7) |
7 (7.1) |
|
|
Age |
|||
|
18-27 |
0 (0.0) |
59 (60.2) |
0.001 |
|
28- 37 |
2 (33.3) |
32 (32.7) |
|
|
38-47 |
3 (50.0) |
6 (6.1) |
|
|
48-57 |
1 (16.7) |
1 (1.0) |
|
|
Sex |
|||
|
Male |
4 (66.7) |
52 (53.1) |
0.684 |
|
BMI |
|||
|
Underweight |
1 (16.7) |
28 (28.6) |
0.753 |
|
Normal weight |
5 (83.3) |
68 (69.4) |
|
|
Overweight |
0 (0.0) |
2 (2.0) |
|
|
Hyperuricaemia |
6 (100.0) |
22 (22.5) |
0.001 |
|
Seafood consumption |
6 (100.0) |
92 (93.9) |
0.532 |
|
Animal innards consumption |
6 (100.0) |
91 (92.9) |
0.498 |
|
Sweetened beverage consumption |
4 (66.7) |
89 (90.8) |
0.121 |
|
Alcohol Consumption |
0 (0.0) |
5 (5.1) |
0.738 |
|
Smoking |
0 (0.0) |
2 (2.0) |
0.724 |
|
Frequency of SCD Crises |
|||
|
More than 2 |
5 (83.3) |
18 (18.7) |
0.002 |
|
Two or fewer |
1 (16.7) |
80 (81.6) |
|
|
Frequency of Admissions |
|||
|
More than 2 |
5 (83.3) |
18 (18.7) |
0.002 |
|
Two or fewer |
1 (16.7) |
80 (81.6) |
|
|
Routine folic acid use |
6 (6.1) |
93 (93.9) |
0.738 |
SCD= Sickle Cell Disease; BMI= Body Mass Index
To cite this abstract in AMA style:
Akintayo R, Adelowo O, Chijioke A, Olanrewaju T, Olufemi-Aworinde K, Akintayo F. Gout Is More Frequent in Sickle Cell Disease Than the General Population [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/gout-is-more-frequent-in-sickle-cell-disease-than-the-general-population/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/gout-is-more-frequent-in-sickle-cell-disease-than-the-general-population/