1Bilal Bengana,2Aicha Ladjouze-Rezig, 3Raaf Nabil Baramtane, 4Chafaa Aimeur, 5Soraya Ayoub, 1Abdenour Boukabous, 1Salima Lefkir-Tafiani
1Rheumatology Department – University Hospital Of Benimessous, 2Specialized Hospital Establishment of Benaknoune, 3Biochemistry Department – Hospital of Bitraria, 4Radiology Department – University hospital of Mustapha Bacha, 5Internal Medicine – University hospital of Beni Messous
Hyperuricemia is a common biological abnormality, often clinically asymptomatic. However, it can announce a gout and be linked to many diseases such as metabolic syndrome, high blood pressure or kidney disease. In fact, the majority of learned societies do not recommend any urate lowering therapy (ULT) as long as the hyperuricemia remains asymptomatic. But it turns out that part of the population with asymptomatic hyperuricemia (AH) develops a gout after a few years particularly with genetic predisposition, but also on certain risk factors that need to be confirmed. By this way, musculoskeletal ultrasound (MUS) can detect “asymptomatic gout” by visualizing signs of urate deposits (UD) in subjects with AH. Our main objective is already to estimate the prevalence of specific signs of gout in Algerian population with AH and assess the factors exposing to UD.
Material(s) and Method(s):
This is a descriptive cross-sectional study from January 2017 to February 2019, with the recruitment of subjects with AH and serum urate level > 60 mg / L, who do not take any ULT and have not associated any chronic inflammatory rheumatism, where we performed a MUS of the knees, metatarsophalangeal joints MTP1, MTP2 and metacarpophalangeal joint MCP2 and MCP3 with the Achilles, patellar and quadricipital tendons.
We retained 258 subjects with AH, 132 women and 126 men (sex ratio = 0.95), the mean age was 59 years, the mean body mass index (BMI) was 28.4 kg / m2, 42 patients were under diuretics, 37 patients reported being on low-dose of aspirin 100 mg daily. The mean rate of serum urate levels was 78 ± 10 mg / L, the prevalence of UD found at the MUS was 22% (n = 58), among them 36 % (21/58) had a sign of the double contour DC on the MTP1 and 29% (17/58) on the knee, 7% (4/58) had tophi on the MTP1 and 3% (2/58) had urate aggregates. The factors
reported to be linked to UD in the sample were: the male gender (p = 0.0016); the high uric acid level (p= 0.0355); BMI (p = 0.0427); taking diuretics for women (p= 0.0002).
Through this work, it is clear that elementary ultrasound lesions related to gout disease are common in a population with AH and concerned one fifth of subjects in our study with a higher risk in men and subjects with obesity and high uric acid level, but also in women taking diuretics. These results need to be enhanced with a randomized controlled study in order to better determine the predisposing factors for gout in any subject with AH.