Gout attacks in chronic alcoholics occur at lower serum urate levels than in nonalcoholics.
OBJECTIVE
To determine if patients with gout with chronic alcoholism have lower serum urate levels than nonalcoholic patients.


METHODS
Of 95 consecutive consults for acute gout at a VA medical center, 42 were excluded from study due to lack of crystal documentation, lack of urate value within 2 years, or treatment with allopurinol or probenecid. The remaining 53 patients were grouped by alcohol use and a retrospective chart review was done for these patients.


RESULTS
Mean intercritical serum urate values for chronic alcoholics and nonalcoholics were similar at 9.7 +/- 2.1 for alcoholics and 9.5 +/- 2.1 for nonalcoholics. Yet, despite these similar intercritical serum urate values, and despite no difference between chronic alcoholics and nonalcoholics in frequency or severity of acute gout flares, patients with chronic alcoholism had index serum urate levels which were significantly lower than those of nonalcoholics. These mean index values, with standard deviations, were 7.7 +/- 1.3 for 15 chronic alcoholics and 10.1 +/- 1.3 for 34 nonalcoholics; p < 0.01).


CONCLUSIONS
Alcoholics and nonalcoholics had comparable intercritical values. However, on presentation with acute arthritis, the index serum urate values for alcoholics were lower than in nonalcoholics. Values for serum urate below 8.5 mg/dl are of less value in excluding gout in chronic alcoholics than in nonalcoholics presenting with acute gout flares.
McGuire Department of Veterans Affairs Medical Center Rheumatology Section, Richmond, VA.
M K
MK
Vandenberg
G
G
Moxley
S A
SA
Breitbach
W N
WN
Roberts
D000368:Aged; D000437:Alcoholism / Q000097:blood* / Q000150:complications*; D015210:Arthritis, Gouty / Q000097:blood* / Q000150:complications* / Q000175:diagnosis; D003404:Creatinine / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013695:Temperance; D014527:Uric Acid / Q000097:blood*
D014527:Uric Acid; D003404:Creatinine