What are the causes of hyperuricaemia and gout?

Causes of hyperuricaemia and gout

Diminished renal excretion:
  • Increased renal tubular reabsorption (Usually genetically determined)
  • Renal failure
  • Lead toxicity (saturnine gout)
  • Lactic acidosis
  • High alcohol (more than 20 units for men, more than 15 units for women); predominantly beer, which contains guanosine
  • Drugs:
      • Thiazide and loop diuretics
      • Low-dose aspirin
      • Cytotoxic agent: Ciclosporin, tacrolimus
      • Pyrazinamide

Increased intake:
  • Game food
  • Seafood
  • Offal
  • Red meat
  • Liver, kidneys
  • Oily fish (mackerel, sardines)
  • Yeast products

Increased production:
  • Myeloproliferative and lymphoproliferative disease
  • Psoriasis
  • High fructose intake
  • Glycogen storage disease
  • Inherited disorders: Lesch-Nyhan syndrome due to hypoxanthine guanine phosphoribosyl transferase

Others:
  • As a component of metabolic syndrome
  • Diet low in vitamin C
  • Associated with osteoarthritis (OA): Proteoglycans and other inhibitors of crystal formation are reduced in osteoarthritic cartilage which leads to crystal formation and deposition

[Information of the image is from Kumar and Clark's Clinical Medicine 9th Edition: 688]

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