Gouty arthritis in Nigerians: clinical and laboratory correlates

Background: Gout has been infrequently reported in black Africans despite the high prevalence in black Americans. There are even fewer reports in West Africans. However, there is a current trend towards increasing frequency among Caucasians, which is mostly due to increasing incidence of obesity, hypertension as well as the consumption of alcohol and other purine loaded foods and drinks. The increasing usage of diuretics and low dosage of aspirin may also be among the contributing factors. These factors are also increasingly been found in black Africans. Objectives: To determine the correlation between the clinical presentations, laboratory findings and pattern of presentation of gout among Nigerians. Design: A retrospective study. Settings: The study was conducted at a private practice rheumatology clinic in Lagos, Nigeria. The clinic serves as a major referral rheumatology clinic for Lagos and the adjoining states. Methods: The case notes of the patients seen over 10 years (January 2001- December 2010) were retrieved. The patients were those who met the American College of Rheumatology Criteria for gout. Data extracted included patients demography, pattern of joint involvement and co-morbid conditions. Necessary literature review was done. Results: A total of 146 subjects were studied. Most of the patients were male (74%), the mean age for all subjects was 53.4 years. Large joints such as the knee and ankle were mostly involved. While monoarticular presentation was mostly observed in half of the subjects, oligoand polyarticular presentations were seen in the remaining half. Tophi were observed in 6.2% of the subjects. Gout was predominantly associated with hypertension. Association was also found with obesity, diabetes, osteoarthritis and alcohol consumption to a lesser extent. Conclusion: Gout seen in Nigerians has both similarities and differences compared to those seen in other black Africans. Key words: Gouty arthritis, Nigerians, Associations, Clinical, Laboratory correlate