Monosodium urate crystal deposits are common in asymptomatic sons of people with gout: The Sons of gout study

Abhishek, Abhishek; Courtney, Philip; Jenkins, Wendy; Sandoval-Plata, Gabriela; Jones, Adrian; Zhang, Weiya; Doherty, Michael

Abstract

Objective To estimate the prevalence and distribution of asymptomatic monosodium urate (MSU) crystal deposition in sons of people with gout.

Method People with gout were mailed an explanatory letter enclosing a postage-paid study-pack to mail to their son(s) ≥20 years old. Sons interested in participating returned a reply-slip and underwent telephone screening. Subsequently they attended a study-visit for blood and urine collection, and musculoskeletal ultrasonography performed blind to serum urate (SU). Images were assessed for double contour sign (DCS), intra-articular or intra-tendinous aggregates/tophi, effusion and power Doppler. Logistic regression was used to examine associations.

Results 131 sons (mean age 43.80 years, body mass index 27.10 kg/m2) completed assessments. 64.1% had SU ≥6 mg/dl, and 29.8% had either DCS or intra-articular aggregates/tophi in ≥1 joint. All participants with MSU deposition had involvement of either 1st metatarsophalangeal joint. 21.4% had intra-tendinous aggregates, and these associated with intra-articular MSU crystal deposits (aOR (95%CI) 2.96(1.17-7.49)). No participant had MSU crystal deposition at SU ≤5 mg/dl, and 24.2% participants with SU between 5-6 mg/dl had ultrasonographic MSU deposition. MSU crystal deposition associated with increasing SU (aOR (95%CI) 1.61(1.10-2.36) for each 1 mg/dl increase).

Conclusion Asymptomatic sons of people with gout frequently have hyperuricemia and MSU crystal deposits. In this study MSU crystal deposits were present in participants with SU >5 mg/dl. Evaluation of people without a family history of gout is needed to confirm if the threshold for MSU crystal deposition is also lower in the general population.

Citation

Abhishek, A., Courtney, P., Jenkins, W., Sandoval-Plata, G., Jones, A., Zhang, W., & Doherty, M. (2018). Monosodium urate crystal deposits are common in asymptomatic sons of people with gout: The Sons of gout study. Arthritis and Rheumatology, 70(11), 1847-1852. https://doi.org/10.1002/art.40572

• Journal Article Type: Article
• Acceptance Date: May 22, 2018
• Online Publication Date: May 27, 2018
• Publication Date: Nov 1, 2018
• Deposit Date: Jun 1, 2018
• Publicly Available Date: Oct 30, 2018
• Journal: Arthritis & Rheumatology
• Print ISSN: 2326-5191
• Electronic ISSN: 2326-5205
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 70
• Issue: 11
• Pages: 1847-1852
• DOI: https://doi.org/10.1002/art.40572
• Keywords: Gout; Crystal arthritis; Ultrasonography; Hyperuricemia; Asymptomatic gout
• Public URL: https://nottingham-repository.worktribe.com/output/934314
• Publisher URL: https://onlinelibrary.wiley.com/doi/abs/10.1002/art.40572
• Contract Date: Jun 1, 2018