From the Guidelines
Secondary causes of gout in the knee include medications, medical conditions, dietary factors, and genetic disorders that increase uric acid levels or reduce its excretion, such as diuretics, chronic kidney disease, obesity, and consumption of purine-rich foods or alcohol. These factors can contribute to the development of gout by increasing uric acid production, decreasing its excretion by the kidneys, or creating conditions where urate crystals are more likely to precipitate in the knee joint, leading to the characteristic painful inflammation of gout 1. Some key secondary causes of gout in the knee include:
- Medications like diuretics (especially thiazides and loop diuretics), low-dose aspirin, cyclosporine, and certain chemotherapy drugs that can increase uric acid levels 1
- Medical conditions such as chronic kidney disease, obesity, metabolic syndrome, diabetes, and hypertension that can reduce uric acid excretion or increase its production
- Dietary factors, particularly consumption of purine-rich foods (organ meats, shellfish, red meat), alcohol (especially beer), and fructose-sweetened beverages
- Rapid weight loss, dehydration, and recent surgery or trauma to the knee that can trigger acute gout attacks in susceptible individuals
- Certain genetic disorders like Lesch-Nyhan syndrome and glycogen storage diseases that can cause secondary gout 1. It is essential to consider these secondary causes when managing gout, as they can impact the effectiveness of treatment and the patient's overall quality of life.
From the FDA Drug Label
Hyperuricemia may be primary, as in gout, or secondary to diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis It may occur with the use of diuretic agents, during renal dialysis, in the presence of renal damage, during starvation or reducing diets, and in the treatment of neoplastic disease where rapid resolution of tissue masses may occur.
Secondary causes of gout in the knee may include:
- Diseases such as acute and chronic leukemia, polycythemia vera, multiple myeloma, and psoriasis
- Use of diuretic agents
- Renal dialysis
- Renal damage
- Starvation or reducing diets
- Treatment of neoplastic disease where rapid resolution of tissue masses may occur 2
From the Research
Secondary Causes of Gout in the Knee
The secondary causes of gout in the knee can be attributed to various factors, including:
- Diet rich in meat and seafood 3
- Alcohol intake 3
- Diuretic use 3
- Chronic kidney disease 3
- Diet heavy in fructose-rich food and beverages 3
- Obesity 3
- Hypertension 3
Medication-Related Causes
Certain medications can also contribute to the development of gout in the knee, such as:
- Diuretics 3
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to treat gout, but their long-term use may have adverse effects 4
Other Factors
Other factors that may contribute to the development of gout in the knee include: