Gout isn’t common in people with lupus, but it occurs more frequently in people with elevated uric acid levels and those who take diuretics.
The link between gout and lupus, or systemic lupus erythematosus (SLE), is complex.
Gout, a type of inflammatory arthritis, is rarely seen with lupus, an autoimmune condition. However, certain factors such as kidney function and the use of diuretics can increase the risk of gout among people with lupus.
Gout is a type of arthritis characterized by sudden and severe attacks of pain, redness, tenderness, and swelling, usually in the joint at the base of the big toe.
It generally occurs when there’s an excess of uric acid, a waste product from the breakdown of purines (natural substances found in many foods), in the local tissue and usually in the bloodstream.
Uric acid can form sharp crystals that accumulate in joints, leading to inflammation and intense pain.
However, you can have a gout attack with typical levels of uric acid. You can also have high blood uric acid and not have gout attacks.
The initial stage of gout is marked by intermittent joint inflammation, which can result from various factors, including injury, infections, medications, dietary choices, or excessive physical activity.
When these bouts of joint inflammation keep happening, they may lead to lasting damage in the affected joints.
Gout is characterized by sudden and severe attacks of symptoms, which typically include:
- Intense joint pain: The most common symptom is a sudden, excruciating pain in one joint, often the big toe. It can also affect other joints like your ankles, knees, elbows, wrists, and fingers.
- Swelling: Your joint becomes swollen and tender and may appear red or purplish.
- Heat: The affected joint can feel hot to the touch.
- Limited range of motion: Due to pain and swelling, you may have restricted range of motion in your joint.
- Persistent discomfort: After the initial attack, some people may experience lingering discomfort or a low-level ache in the joint.
Lupus is a chronic autoimmune disease where the body’s immune system becomes overactive and mistakenly attacks healthy tissues and organs. This can lead to inflammation and damage in various parts of the body, including the skin, joints, kidneys, heart, lungs, brain, and blood cells.
Lupus is characterized by periods of flares, where symptoms get worse, and remissions, where symptoms improve.
Common symptoms of lupus include:
- joint pain and swelling
- skin rashes
- chest pain
- hair loss
- mouth or nose ulcers
- Raynaud’s phenomenon (fingers and toes turning white or blue)
- kidney problems
- brain and nervous system symptoms
- blood disorders
While it was conventionally believed that gout was relatively rare among individuals with lupus, recent research challenges this, suggesting a potentially higher prevalence in specific cases.
For instance, the link between gout and lupus may be more pronounced in people taking loop diuretics, medications that increase urine production by the kidneys.
All individuals with gout had elevated uric acid levels (hyperuricemia), averaging 10.8 mg/DL (uric acid levels over 6 or 7 mg/DL is considered high). There was a significant association between gout and the use of diuretics, particularly among those with impaired kidney function.
The risk of gout is also more common among people with lupus nephritis (LN), a severe kidney complication that affects approximately 40% of people with lupus. LN contributes to higher uric acid levels and, if left untreated, can progress to end-stage renal disease (ESRD).
Although the link between gout and lupus, especially LN, is relatively rare, it’s considered significant.
Can gout be a symptom of lupus?
Gout is not a common symptom directly associated with lupus, and its occurrence in people with lupus is relatively rare.
Still, some individuals with lupus may develop gout as a secondary condition. This can be due to factors such as elevated uric acid levels, medication use, or other health conditions.
In some cases, distinguishing between gout and lupus can be challenging because some symptoms, such as joint pain and inflammation, can overlap. However, gout typically causes intense pain, redness, and swelling in your feet and ankles, while lupus can affect joints throughout your body and involves less swelling.
The relationship between lupus and gout is complex, with recent research challenging the belief that gout is rare in people with lupus. In particular, individuals with LN or those taking loop diuretics may have a higher chance of gout.
If you or a loved one suspects gout or lupus, it’s crucial to seek medical evaluation and diagnosis from a healthcare professional, such as a rheumatologist.
Remember that early diagnosis and appropriate treatment can help improve your quality of life when dealing with these conditions.