Occurrence of Gout in Rheumatoid Arthritis: It Does Happen!

A Population-Based Study

International Journal of Clinical Rheumatology

Adlene J Jebakumar; Prabhu D Udayakumar; Cynthia S Crowson; Eric L Matteson 

Int J Clin Rheumatol. 2013;8(4):433-437


The co-occurrence of gout and RA is rarely reported. In addition to the widespread belief that gout and RA do not, or rarely, coexist in the same patient, it can be difficult to clinically differentiate RA from polyarticular tophaceous gout especially when gout involves the hands. Only 33 cases with coexisting RA and gout have been reported in the English literature prior to this study. These include a report of eight cases of coexisting RA and gout between 1994 and 2005 at Chang Gung Memorial Hospital (Taiwan); this report also included the features of 24 previously reported similar cases in the English literature.[8] A further case with coexisting chronic gout and RA was reported in 2007.[9] Of these 33 previously reported cases, 23 had gout preceding the diagnosis of RA, whereas in our study, only six out of 22 patients had a diagnosis of gout prior to incidence of RA.[8,9] All the previously reported cases of coexisting gout and RA had microscopic evidence of monosodium urate crystals in the synovial fluid or tophus. Rheumatoid factor was present in 24 out of the 33 previously reported cases compared with 14 out of 22 cases in our study. There was predominance of males, with 23 out of the 33 previously reported cases affecting men similar to our findings.[8,9]

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Occurrence of gout in rheumatoid arthritis: it does happen! A population-based study


It has been a popular belief that gout does not typically occur in patients with rheumatoid arthritis (RA). Our aim was to assess the occurrence, prevalence, clinical presentation and possible risk factors for gout in patients with RA.

Patients & methods

We retrospectively reviewed a population-based incidence cohort of patients who fulfilled 1987 ACR criteria for RA between 1980 and 2007. The cumulative prevalence of gout in RA adjusted for the competing risk of death was estimated.

Executive summary


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