Uric Acid Levels During Acute Gout Attacks

We know that a normal serum uric acid level does not exclude gout as the cause of an acutely inflamed joint. But how commonly is the uric acid level normal in this situation? To answer this question, researchers analyzed data from two previously published studies of anti-inflammatory drug therapies for acute gouty arthritis. Patients in whom allopurinol had been initiated within the previous 2 weeks were excluded.

Of 339 patients who presented with acute gout, 14% had serum uric acid levels ≤6 mg/dL, and 18% had levels between 6 mg/dL and 8 mg/dL. Mean uric acid level was about 8.3 mg/dL (7.2 mg/dL in patients taking allopurinol, and 8.5 mg/dL in patients not taking allopurinol).