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Clinical Spectrum and Uric Acid Metabolism

Juan G. Puig, MD; Alfredo D. Michán, MD; Manuel L. Jiménez, MD; Carlos Pérez de Ayala, MD; Felícitas A. Mateos, MD; Carmen F. Capitán, MD; Eugenio de Miguel, MD; Juan B. Gijón, MD

Arch Intern Med. 1991;151(4):726-732.

Abstract
We reviewed the clinical features and uric acid metabolism in 37 female patients with gout. In 32 female patients (86%), gout was diagnosed after menopause. Among the five premenopausal patients, four had renal insufficiency and one had superactivity of phosphoribosylpyrophosphate synthetase. More than 50% of the female patients had osteoarthritis, hypertension, or renal insufficiency or were treated with diuretics. Comparison with 220 male patients with gout showed that female patients developed gout significantly later, more frequently had associated diseases, and more often were receiving diuretics, whereas significantly more male than female patients had alcoholism. The articular features of gout were similar in both groups. However, the prevalence of tophi was higher and its localization different in female than in male patients. Female patients with gout had a higher mean serum urate concentration and a lower mean urinary uric acid excretion than did male patients with gout. These differences were significant and independent of the effects of age, renal insufficiency, alcoholism, or previous diuretic intake. Renal underexcretion of uric acid appears to be more severe in female than in male patients with gout.

(Arch Intern Med. 1991;151:726-732)

Author Affiliations
From the Divisions of Internal Medicine (Drs Puig, Michán, and Capitán), Rheumatology (Drs Pérez de Ayala, de Miguel, and Gijón), and Clinical Biochemistry (Dr Mateos), La Paz University Hospital, and Móstoles General Hospital (Dr Jiménez), Madrid, Spain.

Footnotes
Accepted for publication October 31, 1990.

Reprint requests to Costa Brava, 23,3° D, 28034 Madrid, Spain (Dr Puig).

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