HYPERURICEMIA

SYMPTOMS

In many cases, hyperuricemia may not cause any symptoms and may only be detected through blood tests. However, elevated uric acid levels can predispose individuals to certain conditions, including:

• Gout: Hyperuricemia is a major risk factor for gout, a form of inflammatory arthritis characterized by sudden, severe joint pain, swelling, redness, and warmth, often affecting the big toe but can also occur in other joints.
• Kidney Stones: Urate crystals can accumulate in the kidneys and lead to the formation of kidney stones, causing symptoms such as severe flank pain, hematuria (blood in the urine), and urinary tract infections.
• Tophi: In severe cases of untreated hyperuricemia and gout, urate crystals may form deposits (tophi) under the skin, in joints, or in soft tissues, causing nodules or lumps that can be visible or palpable.

DIAGNOSIS

Diagnosing hyperuricemia involves a blood test to measure uric acid levels. Additional tests may be performed to assess kidney function and evaluate for complications such as gout or kidney stones. Diagnostic steps may include:

• Blood Uric Acid Test: A blood test is performed to measure the concentration of uric acid in the blood. Elevated levels above the normal range (typically >7 mg/dL in men and >6 mg/dL in women) may indicate hyperuricemia.
• Kidney Function Tests: Blood tests such as serum creatinine and estimated glomerular filtration rate (eGFR) are performed to assess kidney function and evaluate for underlying kidney disease.
• Imaging Studies: Imaging modalities such as X-rays, ultrasound, or CT scans may be used to evaluate for signs of gout (such as joint erosions) or kidney stones.

TREATMENT

Treatment of hyperuricemia aims to lower uric acid levels and prevent associated complications such as gout and kidney stones. Treatment options may include:

• Lifestyle Modifications: Dietary changes such as reducing intake of purine-rich foods, limiting alcohol consumption (particularly beer and spirits), maintaining a healthy weight, and staying hydrated can help lower uric acid levels.
• Medications: Pharmacological interventions may be used to lower uric acid levels and prevent gout attacks. Commonly prescribed medications include xanthine oxidase inhibitors (e.g., allopurinol, febuxostat) to inhibit uric acid production and uricosuric agents (e.g., probenecid) to increase uric acid excretion.
• Colchicine: Colchicine may be prescribed to reduce inflammation and prevent gout flares during initiation of urate-lowering therapy.
• Allopurinol Desensitization: In individuals with a history of severe allergic reactions to allopurinol, desensitization protocols may be used to safely reintroduce the medication.