Gout (Hyperuricemia): Complications

The following are the most important diseases or complications that may be contributed to by hyperuricemia or gout:

Eyes and eye appendages (H00-H59).

  • Iridopathia urica – eye involvement in gout.

Endocrine, nutritional and metabolic diseases (E00-E90).

Cardiovascular system (I00-I99)

* Men with gouty arthritis have an increased cardiovascular risk; however, this does not apply to men with pure hyperuricemia.Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

  • Liver damage due to deposits

Musculoskeletal system (M00-M99)

  • Osteoarthritis (younger patients)
  • Bursitis (inflammation of the bursa), usually at the elbow.
  • Chronic arthritis (joint inflammation) (insb. older patients).
  • Chronic joint damage (so-called crystal arthropathy).
  • Irreversible, that is, non-reversible joint changes and destruction.
  • Polyarticular arthritis urica (gout) / polyarthritis urica – multiple localizations possible: cervical spine (atlas dens involvement), sacroiliac joints (erosive sacrooliitis), hands (often in the small finger joints; especially in women), knee joints and feet.
  • Tendovaginitis (tendon sheath inflammation) as an expression of chronic gout.
  • Soft tissue or bone entophi (urate deposits in soft tissues and bones).

Psyche – Nervous System (F00-F99; G00-G99).

  • Erectile dysfunction (ED) – describes a chronic medical condition of at least 6 months’ duration in which at least 70% of attempts to engage in sexual intercourse are unsuccessful
  • Peripheral neuropathy (diseases of the peripheral nervous system) – mononeuropathy (damage to a single peripheral nerve); neurapraxia (dysfunction of a nerve caused by stretching or pressure; 89% on the median nerve in the carpal tunnel) due togout

Genitourinary system (kidneys, urinary tract – sex organs) (N00-N99).

  • Renal insufficiency, chronic (process leading to a slowly progressive reduction in renal function).
  • Priapism – erection lasting > 4 h without sexual stimulation; 95% of cases ischemic or low-flow priapism (LFP), which is very painful; LFP can lead to irreversible erectile dysfunction after only 4 h; therapy: blood aspiration and possibly intracavernosal (i.c.) sympathomimetic injection; “high-flow” priapism (HFP) requires no immediate measures
  • Uratnephropathy (gout nephropathy; gouty kidney) – deposition of uric acid crystals in the kidneys or gout-related kidney disease with associated arterial hypertension.
  • Uratnephrolithiasis (uric acid stones).

Further to cardiometabolic diseases

  • Association studies have identified numerous DNA variants (single nucleotide polymorphisms (SNP)) that genetically determine the expression of uric acid in blood. Mendelian randomization was used to investigate whether elevated uric acid levels are of causal importance for type 2 diabetes, coronary heart disease (CHD), ischemic stroke, and heart failure. Two groups were formed for this purpose: Group I with a total of 28 SNPs previously identified in studies as relevant to uric acid levels. Group II was formed from group I: 14 SNPs were selected that were exclusively associated with uric acid levels and not with other traits (non-pleiotropic association); a genetic risk score (GRS) was then formed from these and related to the cardiometabolic diseases mentioned. Results: Uric acid-specific SNPS were significantly associated with hyperuricemia (gout), but no association with type 2 diabetes, coronary heart disease (CHD), ischemic stroke, and heart failure could be detected from the GRS.