Hyperuricemia Clinical Symptoms

Written by Li Hui Zhi
Endocrinology
Updated on September 02, 2024
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Some patients with hyperuricemia may not have any symptoms, and only discover elevated uric acid levels during a physical examination. However, some patients may experience gouty arthritis, manifesting as redness, swelling, heat, and pain in a localized joint, commonly in the joints of the toes. It may also affect joints like the ankle and elbow. Additionally, some patients may develop gouty nephropathy, leading to renal insufficiency. Therefore, hyperuricemia should be taken seriously to prevent severe conditions such as gouty arthritis and other serious symptoms associated with gout.

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Written by Chen Xie
Endocrinology
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What is hyperuricemia?

Hyperuricemia refers to a condition where, under normal purine diet, fasting blood uric acid levels exceed 420 micromoles per liter in males and 360 micromoles per liter in females. Uric acid is the final metabolic product of human purine compounds. Disorders in purine metabolism lead to hyperuricemia, which is influenced by various factors including genetics, gender, age, lifestyle, dietary habits, medical treatments, and the level of economic development. Clinically, hyperuricemia can be classified into primary and secondary types. Common clinical manifestations mainly include gout, and possibly arthritis, which are closely related to hypertension, diabetes, hyperlipidemia, coronary heart disease, and renal impairment. Therefore, it is necessary to control hyperuricemia.

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Hyperuricemia standards

The diagnostic criteria for hyperuricemia specify that under normal purine diet conditions, if the fasting serum uric acid level on non-consecutive days exceeds 420 micromoles/liter for males and 360 micromoles/liter for females, hyperuricemia can be diagnosed. Hyperuricemia is typically classified into primary hyperuricemia and secondary hyperuricemia, with most patients showing no clear clinical symptoms.

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Written by Chen Xie
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How is hyperuricemia treated?

The treatment of hyperuricemia mainly includes the following points: 1. Improve lifestyle primarily, including a low-purine diet, appropriate exercise, smoking cessation, and increased water intake. 2. Alkalize urine using sodium bicarbonate to maintain urine pH value between 6.2 and 6.9, which facilitates the excretion of uric acid. 3. Avoid drugs that increase uric acid levels, such as diuretics, corticosteroids, and insulin. 4. Use medications that lower uric acid levels; drugs that increase uric acid excretion mainly include probenecid and sulfinpyrazone, and drugs that inhibit uric acid synthesis mainly include febuxostat and allopurinol. However, the treatment with these drugs has specific indications, contraindications, and related side effects. It is advised to use medication under the guidance of a doctor and avoid choosing drugs for treatment arbitrarily.

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Can people with hyperuricemia eat eggs?

In the case of hyperuricemia, we primarily recommend a low-purine diet to prevent the onset of gouty arthritis. As for the nutritional content of eggs, they are considered a food with a moderate level of purines. Therefore, when uric acid levels are relatively high, it is still possible to consume them in moderation. Aside from diet, it is also necessary to drink plenty of water or to alkalize the urine using baking soda tablets even if there is a transient increase in blood uric acid levels. If sufficient water is consumed, it is less likely for deposits to form in the joints. If deposits do not easily form, it also relatively reduces the possibility of triggering inflammatory responses, thus preventing the occurrence of gouty arthritis. Therefore, it is possible to consume an appropriate amount of eggs, but it is also important to drink plenty of water and appropriately alkalize the urine.

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Written by Lin Xiang Dong
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Hyperuricemia manifestations

Most cases of hyperuricemia usually have no obvious clinical symptoms, and it can take years to decades from the increase in blood uric acid to symptom onset, with some individuals never exhibiting obvious clinical symptoms throughout their lifetime. However, as age increases, the incidence of gout becomes higher. When accompanied by acute gouty arthritis, patients may experience severe joint pain. If blood uric acid levels remain high over a long period, this can lead to the formation of gouty tophi and uric acid stones, among other issues.