GOUT ATTACKS IN CHRONIC-ALCOHOLICS OCCUR AT LOWER SERUM URATE LEVELS THAN IN NONALCOHOLICS

Objective. To determine if patients with gout with chronic alcoholism have lower serum urate levels than nonalcoholic patients. Methods. Of 95 consecutive consults for acute gout at a VA medical center, 42 were excluded from study due to lack of crystal documentation, lack of ura te value within 2 years, or treatment with allopurinol or probenecid. The remaining 53 patients were grouped by alcohol use and a retrospect ive chart review was done for these patients. Results. Mean intercriti cal serum urate values for chronic alcoholics and nonalcoholics were s imilar at 9.7 +/- 2.1 for alcoholics and 9.5 +/- 2.1 for nonalcoholics . Yet, despite these similar intercritical serum urate values, and des pite no difference between chronic alcoholics and nonalcoholics in fre quency or severity of acute gout flares, patients with chronic alcohol ism had index serum urate levels which were significantly lower than t hose of nonalcoholics. These mean index values, with standard deviatio ns, were 7.7 +/- 1.3 for 15 chronic alcoholics and 10.1 +/- 1.3 for 34 nonalcoholics; p < 0.01). Conclusion. Alcoholics and nonalcoholics ha d comparable intercritical values. However, on presentation with acute arthritis, the index serum urate values for alcoholics were lower tha n in nonalcoholics. Values for serum urate below 8.5 mg/dl are of less value in excluding gout in chronic alcoholics than in nonalcoholics p resenting with acute gout flares.