What are the causes of hyperuricaemia and gout?

Causes of hyperuricaemia and gout

Diminished renal excretion:

• Increased renal tubular reabsorption (Usually genetically determined)
• Renal failure
• Lead toxicity (saturnine gout)
• Lactic acidosis
• High alcohol (more than 20 units for men, more than 15 units for women); predominantly beer, which contains guanosine
• Drugs:
• Thiazide and loop diuretics
• Low-dose aspirin
• Cytotoxic agent: Ciclosporin, tacrolimus
• Pyrazinamide

Increased intake:

• Game food
• Seafood
• Offal
• Red meat
• Liver, kidneys
• Oily fish (mackerel, sardines)
• Yeast products

Increased production:

• Myeloproliferative and lymphoproliferative disease
• Psoriasis
• High fructose intake
• Glycogen storage disease
• Inherited disorders: Lesch-Nyhan syndrome due to hypoxanthine-guanine phosphoribosyl transferase

Others:

• As a component of metabolic syndrome
• Diet low in vitamin C
• Associated with osteoarthritis (OA): Proteoglycans and other inhibitors of crystal formation is reduced in osteoarthritic cartilage which leads to crystal formation and deposition

[Information of the image is from Kumar and Clark's Clinical Medicine 9th Edition: 688]