It is well-established that patients with a history of gout are more susceptible to experiencing gastrointestinal bleeding. Gout flare during active gastrointestinal bleeding poses a significant challenge due to the gastrointestinal side effects of anti-inflammatory therapy. This study sought to investigate the risk factors associated with gout flares during episodes of gastrointestinal bleeding.
We conducted a retrospective observational study involving 94 patients who experienced active gastrointestinal bleeding and had a history of gout. This study was conducted at Jinhua Municipal Central Hospital from January 2019 to October 2022. We collected and recorded demographic information and clinical characteristics.
Among the gout flare patients, hyperuricemia and intravenous fat emulsion therapy were more prevalent compared to those who remained stable (81.6% vs. 57.8% and 46.9% vs. 24.4%, p < 0.05). Multivariate logistic regression analysis revealed that both hyperuricemia (odds ratio 2.741, 95% CI 1.014-7.413, p = 0.047) and intravenous fat emulsion therapy (odds ratio 2.645, 95% CI 1.046-6.686, p = 0.040) were independent predictors of gout flares. Furthermore, gout attacks occurred sooner in patients receiving intravenous fat emulsion therapy compared to those not receiving it (median: 4 days (interquartile range: 2) vs. median: 5 days (interquartile range: 2.25), p = 0.049).
Our study revealed a high incidence of gout flares during episodes of active gastrointestinal bleeding, with patients undergoing intravenous fat emulsion therapy and those with hyperuricemia being at increased risk.

OBJECTIVE: To study the correlation between achilles tendon rupture (ATR) and hyperuricemia, also verify the known risk factors for ATR.
METHODS: A retrospective review of 488 subjects was performed (182 with Achilles tendon rupture, 306 controls with ankle sprains). Demographic variables and risk factors for rupture were tabulated and compared. The baseline data and related indicators were compared, and the risk factors of ATR were analyzed by constructing a binary logistic regression model.
RESULTS: Univariate logistic analysis showed that BMI, smoking, and hyperuricemia were risk factors for the development of ATR (OR = 1.65, 95%CI 1.13-2.42, P = 0.01; OR = 1.47, 95%CI 1.00-2.24, P < 0.05; OR = 2.85, 95%CI 1.84-4.42, P < 0.01). Multifactorial analysis showed that BMI ≥ 25 kg/m2, smoking, and hyperuricemia were independent risk factors for the development of ATR (OR = 1.66, 95%CI 1.11-2.49, P = 0.01; OR = 2.15, 95%CI 1.28-3.60, P < 0.01; OR = 3.06, 95%CI 1.92-4.89, P < 0.01). Among the blood biochemical indicators, total cholesterol (TC) and uric acid (UA) were independent risk factors for the occurrence of ATR (OR = 1.54, 95% CI 1.12-2.12, P = 0.01; OR = 1.01, 95% CI 1.01-1.01, P < 0.01).
CONCLUSIONS: Our study confirmed that, as in previous results, higher BMI, smoking, and total cholesterol are risk factors for ATR, Hyperuricemia may contribute to the development of ATR, and adjunctive tests for TC and UA in the blood biochemistry may be helpful in predicting the risk of ATR.

UNASSIGNED: Hyperuricemia constitutes a major public health issue due to its implication in many chronic diseases and metabolic syndromes. We propose to study the prevalence and associated factors of hyperuricemia to diagnose asymptomatic patients and make prognoses on the state of health of the patients.
UNASSIGNED: An analytic cross-sectional study has been carried out at the Bafoussam Regional Hospital and the Biochemistry laboratory of the Université des Montagnes over 2 months. Sociodemographic and anthropometric characteristic was obtained; a blood sample was collected from the chosen patients and a biochemical test (uric acid, creatinine, urea, total cholesterol, high density lipoproteins cholesterol, triglyceride) was analyzed by spectrophotometric method. Statistical tests were carried out using SPSS statistical software. Logistic regression analyses identified factors associated with variables of interest. The significance was measured by a p < 0.05 with a confidential level of 95%.
UNASSIGNED: The patient population was made up of 100 patients. The sex ratio was 1.22 in favor of men. The prevalence of hyperuricemia in our study was 28.0% with 31.1% in women and 27.3% in men. The mean average of uric acid in the hyperuricemia population was 7.50 ± 1.24 mg/L and the normal uricemia population was 4.69 ± 1.49 mg/L (p < 0.0001). The mean average triglyceride in the hyperuricemia population was 143 ± 14 and 117.55 ± 55.52 mg/dL in normal uricemia with p = 0.046. Age range [35-45] and hypertriglyceridemia have been associated with hyperuricemia with respectively (odds ratio [OR] = 4.07, p < 0.015) confidence interval, CI: [0.89: 97.0]) and ([OR = 2.50, p < 0.046] CI: [1.01: 6.09]).
UNASSIGNED: The prevalence of hyperuricemia was relatively high and has been associated with metabolic disorders in the population. It is necessary to focus on early diagnoses, treatment, and early intervention in view to prevent chronic diseases associated with hyperuricemia.

Wang, Si-Yang, Jun Liang, and Jing-Hong Zhao. A Case of High-Altitude Renal Syndrome. High Alt Med Biol. 00:000-000, 2024.-Epidemiological studies have confirmed that high-altitude exposure increases the risk of proteinuria. The concept of high-altitude renal syndrome (HARS) was proposed in 2011. HARS is a group of clinical syndromes consisting of high-altitude polycythemia, hyperuricemia, systemic hypertension, and microalbuminuria. At present, no standardized and unified treatment methods of HARS have been proposed. We report a case of HARS without other organ involvement in a young man exposed to high altitude. Decreasing the red blood cell count and hemodynamic changes as soon as possible may be of great importance for reducing proteinuria. In addition, angiotensin receptor blockers are effective in the treatment of HARS.

The aim was to evaluate the effect, if any, of asymptomatic hyperuricemia on distal femoral cartilage thickness through musculoskeletal ultrasonography. A total of 66 participants were evaluated in this prospective, controlled study, including 33 asymptomatic hyperuricemic patients who presented at our outpatient clinic between January and April 2020, and 33 normouricemic subjects matched for age, gender and body mass index. Participants with systemic diseases affecting uric acid level such as chronic renal failure, psoriasis, gout, etc., participants using drugs that can affect uric acid level, and those with knee complaints were excluded from the study. Cartilage thickness measurements were taken using musculoskeletal ultrasonography from the right medial condyle, right lateral condyle, right intercondylar area, left medial condyle, left lateral condyle and left intercondylar area. Distal femoral cartilage thickness was lower in all measurement areas in the asymptomatic hyperuricemia group than in the normouricemic group (p<0.05 all). No correlation was noted between uric acid levels and cartilage thickness in all measurement areas in either the asymptomatic hyperuricemic or normouricemic group (p>0.05 all). We think that distal femoral cartilages seem to be thinner in participants with asymptomatic hyperuricemia. Longitudinal studies are needed to determine whether asymptomatic hyperuricemia will lead to knee osteoarthritis in individuals, although we believe that people with asymptomatic hyperuricemia should be informed accordingly in order to prevent development of potential knee osteoarthritis.

Spinal gout is a rare occurrence, and the combination of gout with lumbar spondylolysis has not been reported. We present a unique case involving a 29-year-old male who complained of low back pain for 1 month. Computed tomography and magnetic resonance imaging revealed articular subchondral erosions and a mass in the left L5-S1 facet joints. Initially treated for a spinal infection, the patient subsequently underwent lumbar spinal canal decompression and fusion, achieving complete relief. Postoperative pathology confirmed the spinal lesions to be tophaceous gout. Dual-energy CT or biopsy can assist in confirming the diagnosis. This report discusses another rare case of tophaceous gouty arthritis with spondylolysis to be added to the literature.

Medical conditions such as the nutcracker phenomenon, midgut malrotation, and congenital solitary kidney are rare. Hereby, we present a 21-year-old South Asian male referred to the nephrology clinic for hypertension and increased serum creatinine and was diagnosed with all three conditions. We briefly reviewed the literature on this subject. We present this case report to highlight the complex interplay of multiple renal and gastrointestinal anomalies and to emphasize the importance of a multidisciplinary approach in patient care to optimize outcomes and quality of life.

Autosomal dominant tubulointerstitial kidney disease (ADTKD) is a low-prevalence pathology mainly associated with pathogenic variants of the UMOD gene. It is characterized by the progressive deterioration of renal function, associated with hyperuricemia and accompanied by a family history of gout or hyperuricemia. Often, clinical variability and a lack of molecular testing results in diagnostic failure to determine the ADTKD-UMOD association. Case presentation: We describe the case of a 14-year-old male who presented to the nephrology service with hyperuricemia, renal ultrasonographic changes, and progression to chronic kidney disease in 4 years. He had a family history of hyperuricemia. A probable genetic disease with an autosomal dominant inheritance pattern was considered, confirmed by the presence of a probably pathogenic variant of the UMOD gene, not previously reported in the literature. Conclusion: The investigation of this case led to the identification of a new variant in the UMOD gene, broadening the spectrum of known variants for ADTKD-UMOD. In addition, in this case, a comprehensive anamnesis, that takes into account family history, was the key point to carry out genetic tests that confirmed the diagnosis suspicion. Directed Genetic tests are currently an essential diagnostic tool and should be performed as long as they are available and there is an indication to perform them.

Acute gouty arthritis is a recognized complication of hyperuricemia and one of the most common forms of inflammatory arthritis in adults. Drug-induced hyperuricemia is increasingly prevalent in clinical practice. Diuretics, antitubercular medications, and immunosuppressants are the common drugs associated with hyperuricemia. Oral isotretinoin is the drug of choice for different forms of severe acne and is rarely associated with hyperuricemia. We present the case of a 30-year-old male with severe acne vulgaris who was prescribed isotretinoin and later presented with acute gout. The patient developed hyperuricemia and swelling of the right first metatarsophalangeal joint within two months of isotretinoin commencement. There was a second episode of similar joint swelling three months later, parallel to the isotretinoin rechallenge. The dose of isotretinoin was reduced with the addition of febuxostat. The patient did not develop further episodes and remained symptom-free without urate-lowering therapy.

BACKGROUND: Cystinuria and xanthinuria are both rare genetic diseases involving urinary calculi. However, cases combining these two disorders have not yet been reported.
METHODS: In this study, we report a case of cystinuria with xanthine stones and hyperuricemia. The 23-year-old male patient was diagnosed with kidney and ureteral stones, solitary functioning kidney and hyperuricemia after admission to the hospital. The stones were removed by surgery and found to be composed of xanthine.
CONCLUSIONS: Genetic testing by next-generation sequencing technology showed that the patient carried the homozygous nonsense mutation c.1113 C> A (p.Tyr371*) in the SLC3A1 gene, which was judged to be a functionally pathogenic variant. Sanger sequencing revealed that the patient\'s parents carried this heterozygous mutation, which is a pathogenic variant that can cause cystinuria. The 24-h urine metabolism analysis showed that the cystine content was 644 mg (<320 mg/24 h), indicating that the patient had cystinuria, consistent with the genetic test results. This case shows that cystinuria and xanthine stones can occur simultaneously, and provides evidence of a possible connection between the two conditions. Furthermore, our findings demonstrate the potential value of genetic testing using next-generation sequencing to effectively assist in the clinical diagnosis and treatment of patients with urinary calculi.