Rheumatoid arthritis and gout

Gout and Rheumatoid Arthritis

Can rheumatoid arthritis cause gout?

1% of the American population suffers from rheumatoid arthritis. It is 2 to 3 times more common in women than in men but men do suffer the worst symptoms. Middle age is when you’ll usually see the disease develop and sadly young children can also get rheumatoid arthritis. Rheumatoid arthritis or RA as they call it, is an autoimmune disease and no one understands how the immune system which is designed to protect your health by attacking foreign invaders like bacteria and viruses; this form of inflammatory arthritis instead attacks your body’s own tissues; more specifically the synovium which comprises of a thin membrane that lines the joints. As fluid builds in the joints and basically getting attacked, the result will be pain in the joins and inflammation that can occur anywhere in the body.

The similarities and differences between Gout and RA

Like gout, rheumatoid arthritis is a chronic disease, meaning it can’t be cured as of this writing. Like gout, RA sufferers experience intermittent bouts called flares. The disease may be continuously active for some RA sufferers but others can enjoy long periods of remission where they do not experience any disease symptoms whatsoever. Like gout, RA can eventually lead to joint destruction, organ damage, damage to cartilage, tendons, and ligaments and even disability! Like gout both diseases cause redness, swelling and pain in the joints but in RA it can also become painful but won’t always be red or swollen. A difference between gout sufferers and RA sufferers is that the symptoms of RA varies from person to person and can even change on a daily basis, the pain, inflammation and swelling can come from any part of your body. Gout will usually occur in the foot and more commonly at the base of the big toe whereas rheumatoid arthritis usually affects the any joint on either side of your body and is more apparent in your small joints like the hands, wrists and feet. Rheumatoid arthritis pain also varies in intensity sometimes it’s mild and other times the pain is very excruciating. It’s easy to see how one can confuse rheumatoid arthritis with gout and vice versa. What you should know as a fact is that rheumatoid arthritis and gout may occur together.

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A study in Germany conducted by study researcher Christina Petsch of the University of Erlangen-Nuremberg in Germany followed 100 women and male patients with RA with the average age of 63 and all had high uric acid levels in their blood. Out of those 100 patients, 13 of them had positive scans for uric acid deposits in their feet. A Mayo Clinic study and presented at the American College of Rheumatology also found that RA patients can also get gout later on. Lead study author Eric Matteson M.D. quotes: “The reason it was thought that rheumatoid arthritis patients didn’t get gout likely had to do with the way rheumatoid arthritis used to be treated, Dr. Matteson says. Such patients used to be given aspirin in high doses, and that coincidentally helped their kidneys expel uric acid. Aspirin is no longer used much for rheumatoid arthritis, and that, combined with a rise in obesity, is likely fuelling gout in rheumatoid arthritis patients,” he says.

It is probably true that flares of rheumatoid arthritis in some cases might have actually been flares of gout, and that the gout wasn’t diagnosed; it wasn’t realized that it was a coexistent problem,” Dr. Matteson says. “Awareness that gout does exist in patients with rheumatoid arthritis hopefully will lead to better management of gout in those patients.”

In the Mayo Clinic study they researched 813 RA sufferers between 1980 and 2007. What they found was that 22 patients developed gout over the 27 year period and the big toe was the most affected joint. The conclusion here is thatthe presence of one does not seem to completely protect against the other. Some good news, the prevalence of gout in patients with rheumatoid arthritis is much lower than in the general population.

Posted by Spiro Koulouris

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