Some Lupus Patients at Risk for Gout Related to Diuretic Use

Although gout has historically been thought to be a rare in patients with SLE, a recent case series suggests that the incidence of gout in SLE may be greater than previously thought, University of Michigan researchers report.

Lupus patients may be at risk for gout, a University of Michigan team reports at the 2015 American College of Rheumatology Annual Meeting in San Francisco, CA.

Eric Wise and colleagues in Ann Arbor, MI, said 27 of 856 lupus cohort patients (3.2%) were identified as having gout. Of those, six had crystal-proven gout. The average age was 55 and the average BMI was 33.5.

All patients were hyperuricemic.

A significant number of the lupus patients had been treated with diuretics. Twelve had received a loop diuretic and six got a thiazide diuretic. More than half (17) had reduced renal function and 25 patients were taking prednisone.

Six of the patients had received kidney transplant and were taking cyclosporine.

"There was a striking association between gout and the administration of a diuretic, either for edema or other indications, especially in the setting of impaired renal function," the team noted in their abstract. "Lupus patients with a history of compromised renal function who are being treated with diuretics should be monitored closely for hyperuricemia and symptoms of gout," they concluded.