Publication:

Atypical manifestation of hyperuricemia in the Indian population: a clinical and biochemical assessment and treatment guidelines

Background Podgora, the clinical presentation of gout presents no problem in diagnosis but hyperuricemia leading to some unusual presentation with musculoskeletal disorders and is often missed. This study had been conducted to analyze the disturbances of uric acid metabolism and subsequent role of uric acid in the pathogenesis of various disorder including cardiovascular, renal and various musculoskeletal disorders and to determine the disease related upper level of SUA in Indian population in both vegetarians and non-vegetarians.

Methods Serum uric acid (by nephelometric method) was assessed in 1084 individuals during January 2018- December 2022 at a single center at Max Super Specialty Hospital, Patparganj, New Delhi with complaint of pain and swelling in joints and various other musculoskeletal problems. Out of these 48.80% were vegetarians and 51.20 were nonvegetarians.

Results Looking at the symptomatology, only 18.50% presented with podagra as their chief complaint followed by 15.40% with generalized myalgia, 14.39% cases of plantar fasciitis and rest including tennis elbow, knee and ankle synovitis, interscapular fibrofascitis, bursitis anserine and various other musculoskeletal problems. In 76% cases with uric acid level more than 7mg/dl were having hypertriglyceridemia. Mild to moderate hypertension had been noted in 53% cases of those having SUA level more than 7 mg/dl.

Conclusions In present study, it concluded that musculoskeletal symptoms related uric acid level should be lower around 5.5 mg/dl. SUA levels in vegetarians and non-vegetarians did not differ significantly. The high haemoglobin percent in most of the individuals gives an idea that hyperuricemia is related to good nutritional status.