Hyperuricaemia and gout

This chapter outlines the sources of uric acid and describes its metabolism, before discussing the diagnosis, clinical investigations, and management of conditions associated with hypouricaemia and hyperuricaemia. Sources of purines are foods such as red meat, shellfish, and cream sauces, their de novo synthesis and the salvage pathway. The purine synthetic pathway involves a series of enzyme-catalysed reactions that result in the formation of uric acid. Hyperuricaemia is a concentration of uric acid in plasma above the reference range and may result from overproduction or decreased excretion of uric acid. Meanwhile, gout is an inflammatory disease diagnosed by hyperuricaemia and the presence of crystals of monosodium urate in the synovial fluid. There are four stages of gout: asymptomatic, acute, intercritical, and chronic tophaceaous gout. Gout is treated with nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics.