Coexistence of gout and rheumatoid arthritis in Nairobi, Kenya

Abstract

Background: There is a widespread belief that gout and RA rarely coexist in the same patient. Given that there is an excess burden of cardiovascular disease in patients with RA, this is compounded by hyperuricemia. The purpose of this study was to describe the clinical profiles of patients with coexistent gout and rheumatoid arthritis.

Methodology: This was a retrospective study to be carried out at the Nairobi Arthritis Clinic. The sample population comprised of all medical records of patients with RA and gout. The files were retrospectively reviewed from January 2009 to December 2017.

Results: The cohort included 13 patients with the diagnosis of rheumatoid arthritis and gout seen at the clinic between January 2009 and December 2017. Majority of the study participants were male (9/13) with a mean age of 60.8 years. The mean age of diagnosis of rheumatoid arthritis and gout was 55.25 years and 63 years respectively. The participants were obese with a mean of 31.4. Majority tested positive (10/13) for either or both rheumatoid factor and anti-citrulated peptide antibody. Urate acid crystals were identifi ed in 10 of the 13 participants. All the participants had used glucocorticoids with a further 4 on diuretics which were later stopped.

Conclusions: Coexistence of rheumatoid arthritis and gout is still rare in Kenya. Being male and obese having either rheumatoid arthritis or gout increasing the chance of developing both diagnoses. A large number had tophithus in patients
with tophaceous gout not improving on standard therapy an alternative diagnosis could be rheumatoid arthritis.

Keywords: Gout , Rheumatoid arthritis, Kenya