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Rationale:
- Patients with these complicated conditions need treatment of each disorder present.
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Evidence:
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Comments:
- A misdiagnosis of gout is common. In one study, half of the patients seen in consultation had an incorrect diagnosis, most
commonly those with psoriatic arthritis or pseudogout (35). Most of these patients had been given uric acid-lowering therapies.
- Some patients with gout also have other types of inflammatory arthritis. Patients with psoriasis may be more prone to develop
gout because the hyperproliferative nature of psoriasis often leads to hyperuricemia. Otherwise, the frequency of concurrent
arthritis may be close to the product of the relative frequencies (e.g., about 1% of patients with gout ought to have rheumatoid
arthritis, because that is the background prevalence of rheumatoid arthritis).
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Grace P. Teal, MD (deceased) has no financial relationships with pharmaceutical companies, biomedical device manufacturers, or health-care related organizations.
Howard A. Fuchs, MD, is a consultant for TAP Pharmaceuticals.
Steven E. Weinberger, MD, FACP, Acting Editor, PIER, has stock holdings in Glaxosmithkline and Abbott.
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The information included herein should never be used as a substitute
for clinical judgment and does not represent an official position of
ACP. Because all PIER modules are updated regularly, printed web pages
or PDFs may rapidly become obsolete. Therefore, PIER users should
compare the date of the last update on the website with any printout
to ensure that the information being referred to is the most current
available.
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PIER is copyrighted (c) 2009 by the American College of Physicians,
190 N. Independence Mall West, Philadelphia, PA 19106-1572, USA.
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Gout
> Consultation for Management
