What are the gout examination items? These three must be done

Gout is a type of disease that is common among middle-aged and elderly people. Before gout is diagnosed, patients need to seek medical attention for a series of examinations. So, what are the gout examination items?

1. Blood and urine routine tests and erythrocyte sedimentation rate

1. Routine blood test and erythrocyte sedimentation rate examination During the acute attack period, the peripheral blood leukocyte count is elevated, usually (10-20)×109/L, and rarely exceeds 20×109/L. Neutrophil counts increased accordingly. People with decreased renal function may have mild to moderate anemia. The erythrocyte sedimentation rate increases, usually less than 60 mm/h.

2. Routine urine examination generally shows no changes in the early stage of the disease. Those with kidney involvement may have proteinuria, hematuria, pyuria, and occasionally tubular urine. Those with concurrent kidney stones may have obvious hematuria and the excretion of acidic urinary stones.

2. Blood uric acid determination

During the acute attack period, the serum uric acid level of most patients increases. It is generally believed that the uricase method has diagnostic value when the concentration is 416 μmol/L (7 mg/dl) for men and >357 μmol/L (6 mg/dl) for women. If uricosuric drugs or cortical hormones have been used, the serum uric acid level may not be high. The remission period can be normal. 2% to 3% of patients present with typical gout attacks but have serum uric acid levels lower than the above levels. There are three explanations: ① The temperature gradient between the core body temperature and the peripheral joint temperature is large; ② The body is in a state of stress and secretes more adrenal cortical hormones, which promotes the excretion of serum uric acid, while the sodium urate content in the distal joints is still relatively high; ③ The influence of treatment with uricosuric drugs or corticosteroids.

3. Determination of uric acid content

In the case of a purine-free diet and without taking medications that affect uric acid excretion, the total uric acid content in the urine of a normal male adult within 24 hours does not exceed 3.54mmol/(600mg/24h). 90% of primary gout patients have uric acid excretion of less than 3.54mmol/24h. Therefore, normal uric acid excretion cannot rule out gout, but uric acid levels greater than 750 mg/24 h indicate excessive uric acid production, especially non-renal secondary gout. When blood uric acid levels increase, uric acid levels also increase significantly.