Triggers of acute attacks of gout, does age of gout onset matter? A primary care based cross-sectional study

Abstract

ObjectivesTo determine the proportion of people with gout who self-report triggers of acute attacks; identify the commonly reported triggers, and examine the disease and demographic features associated with self-reporting any trigger(s) of acute attacks of gout.MethodsIndividuals with gout were asked to fill a questionnaire enquiring about triggers that precipitated their acute gout attacks. Binary logistic regression was used to compute odds ratio (OR) and 95% confidence intervals (CI) to examine the association between having ≥1 self-reported trigger of acute gout and disease and demographic risk factors and to adjust for covariates. All statistical analyses were performed using STATA.Results550 participants returned completed questionnaires. 206 (37.5%) reported at least one trigger of acute attacks, and less than 5% reported >2 triggers. Only 28.73% participants reported that their most recent gout attack was triggered by dietary or lifestyle risk factors. The most frequently self-reported triggers were alcohol intake (14.18%), red-meat or sea-food consumption (6%), dehydration (4.91%), injury or excess activity (4.91%), and excessively warm or cold weather (4.36% and 5.45%). Patients who had onset of gout before the age of 50 years were significantly more likely to identify a trigger for precipitating their acute gout attacks (aOR (95%CI) 1.73 (1.12–2.68) after adjusting for covariates.ConclusionMost people with gout do not identify any triggers for acute attacks, and identifiable triggers are more common in those with young onset gout. Less than 20% people self-reported acute gout attacks from conventionally accepted triggers of gout e.g. alcohol, red-meat intake, while c.5% reported novel triggers such as dehydration, injury or physical activity, and weather extremes.

Late diagnosis of Lesch–Nyhan disease complicated with end-stage renal disease and tophi burst: a case report

“…Repetitive trauma from the habit of hand biting and improper exercise during physiotherapy may exacerbate gout attacks. In this case, gout attacks were characterized by intense swelling, pain, and tophi burst [15]. Cases of tophus burst in chronic gout in elderly were reported at serum uric acid level of 10.2 mg/dL (606.7 mmol/L), 532 mmol/L, and 8.8 mg/dL (523.42 mmol/ L); much lower compared to our patient [16][17][18].…”

Rare genetic variants in interleukin-37 link this anti-inflammatory cytokine to the pathogenesis and treatment of gout

“…We also show that rare variants in IL37 are linked with either increased disease severity or an earlier onset of gout. In our discovery cohort, the mean age of gout onset was 29 for patients carrying a rare IL37 variant, compared with 51 for non-carrier patients 46. Likewise, EP patients carrying p.(N182S) developed gout at a significantly earlier age compared with non-carrier patients.…”

Gout in Pregnancy: A Rare Phenomenon

“…Our patient suffered an episode of primary gout in the first trimester of pregnancy with no predisposing factors, likely precipitated by H. influenzae sepsis with dehydration secondary to sepsis-related vomiting and hyperemesis gravidarum diagnosed this pregnancy [ 7 ]. Gout is rare in women of reproductive age, particularly during pregnancy, due to the estrogen’s uricosuric effects [ 1 , 2 ].…”