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Brazilian Society of Rheumatology and Brazilian Society of Clinical Pathology/Laboratory Medicine recommendation for serum uric acid test reports on patients undergoing treatment for gout

Advances in Rheumatology volume 64, Article number: 73 (2024) Cite this article

Gout is the most common form of inflammatory joint disease in humans [1, 2]. In recent decades, its prevalence has increased due to various factors: dietary habits, increased longevity, the use of hyperuricemic drugs, chronic kidney disease, and metabolic syndrome [1, 2]. Gout is a chronic disease caused by the deposition of monosodium urate (MSU) crystals in various tissues, manifesting as painful and potentially destructive arthritis in the context of hyperuricaemia [2,3,4]. Population studies in healthy individuals indicate a normal distribution of serum uric acid levels ranging from 3.4 to 7 mg/dL. However, hyperuricemia is defined as a serum urate concentration that exceeds its solubility at normal pH, body temperature, and sodium concentration [5]. The solubility threshold for uric acid is typically 6.8 mg/dL, but in peripheral joints, where body temperature is lower, the threshold is even lower. Therefore, during the treatment of gout, it is recommended that serum urate levels be maintained below 6 mg/dL [2,3,4,5]. Adequate control of hyperuricemia is crucial for preventing painful and disabling acute gout attacks. Both the prevention of precipitation and the resorption of already deposited MSU crystals depend on maintaining a serum uric acid level below its solubility threshold. In light of this, the Brazilian Society of Rheumatology and the Brazilian Society of Clinical Pathology/Laboratory Medicine recommend that serum uric acid test reports include a note stating that “In patients undergoing treatment for gout, serum uric acid levels below 6 mg/dL are recommended”. This therapeutic target (serum uric acid level < 6 mg/dL), which is well-supported in clinical practice, provides both physicians and patients with a clear and actionable goal, improving the monitoring and management of gout.

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Authors and Affiliations

  1. Serviço de Reumatologia, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil

    Geraldo da Rocha Castelar Pinheiro

  2. Sociedade Brasileira de Reumatologia, São Paulo, Brazil

    Geraldo da Rocha Castelar Pinheiro, Marco Antônio Araújo da Rocha Loures & Luís Eduardo Coelho Andrade

  3. Departamento de Medicina, Universidade Estadual de Maringá, Maringá, Paraná, Brazil

    Marco Antônio Araújo da Rocha Loures

  4. Departamento de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil

    Luís Eduardo Coelho Andrade

  5. Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil

    Fabiano de Almeida Brito & Leonardo de Souza Vasconcellos

  6. Sociedade Brasileira de Patologia Clínica/Medicina Laboratorial, Rio de Janeiro, RJ, Brazil

    Fabiano de Almeida Brito & Leonardo de Souza Vasconcellos

  7. Rheumatology Discipline, Pedro Ernesto University Hospital, Blvd. 28 de Setembro 77 Vila Isabel, Rio de Janeiro, RJ, 20551-0301, Brazil

    Geraldo da Rocha Castelar Pinheiro

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  1. Geraldo da Rocha Castelar Pinheiro
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  2. Marco Antônio Araújo da Rocha Loures
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  3. Luís Eduardo Coelho Andrade
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  4. Fabiano de Almeida Brito
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  5. Leonardo de Souza Vasconcellos
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Contributions

G.R.C.P, L.E.C.A., F.A.B., L.S.V. wrote the main manuscript text and all authors (G.R.C.P, M.A.A.R.L., L.E.C.A., F.A.B., and L.S.V.) reviewed the manuscript.

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Correspondence to Geraldo da Rocha Castelar Pinheiro.

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da Rocha Castelar Pinheiro, G., da Rocha Loures, M.A.A., Andrade, L.E.C. et al. Brazilian Society of Rheumatology and Brazilian Society of Clinical Pathology/Laboratory Medicine recommendation for serum uric acid test reports on patients undergoing treatment for gout. Adv Rheumatol 64, 73 (2024). https://doi.org/10.1186/s42358-024-00415-6

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Advances in Rheumatology

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