Fast Five Quiz: Gout and Pseudogout

Herbert S. Diamond, MD


December 04, 2019

Individual gout flares are often triggered by acute increases or decreases in urate levels that may lead to the production, exposure, or shedding of crystals. Many factors can result in urate level changes, including acute alcohol ingestion, acute overindulgence in foods high in purines, rapid weight loss, dehydration, or trauma.

Similarly, flares can be precipitated by additions of or changes in dosage of medications that raise or lower uric acid levels. Medications that increase uric acid levels via effects on renal tubular transport include:

  • Loop and thiazide diuretics (eg, hydrochlorothiazide)

  • Niacin

  • Low-dose aspirin

  • Cyclosporine

  • Pembrolizumab

Agents that lower levels of uric acid include:

  • Radiocontrast dyes

  • Xanthine oxidase inhibitors (eg, allopurinol, febuxostat)

  • Uricosurics (eg, probenecid)

Read more about the etiology of gout and pseudogout.


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