Are blood studies useful in the diagnosis of gout and pseudogout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Blood studies may reveal abnormalities associated with gout or common comorbid conditions. In addition, abnormal results on renal function or liver function studies may affect the selection of therapy.

Obtaining an accurate measure of the patient’s renal function before deciding on therapy for gout is important. The glomerular filtration rate can be estimated by using formulas such as the Modification of Diet in Renal Disease (MDRD) Study equation or the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Serum creatinine evaluation alone can underestimate renal dysfunction in elderly patients or in patients with low muscle mass.

The WBC count may be elevated in patients during the acute gouty attack, particularly if it is polyarticular. Hypertriglyceridemia and low levels of high-density lipoprotein (HDL) are associated with gout. Glucose measurement is useful because patients with gout are at increased risk for the development of diabetes mellitus.

Pseudogout attacks can be triggered by many metabolic abnormalities. Thus, patients who have an initial attack of arthritis with CPP crystals should have a workup that includes a chemistry screen; serum magnesium, calcium, iron and iron-binding levels; and thyroid function tests.

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