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Review
. 2022 Feb 26;24(1):58.
doi: 10.1186/s13075-021-02706-5.

Clinical features of gout in adult patients with type Ia glycogen storage disease: a single-centre retrospective study and a review of literature

Na Xu  1 , Xinxin Han  1 , Yun Zhang  1 , Xiaoming Huang  1 , Weiguo Zhu  1 , Min Shen  2 , Wen Zhang  2 , Chen Jialin  1 , Min Wei  3 , Zhengqing Qiu  4 , Xuejun Zeng  5
Affiliations
Review

Clinical features of gout in adult patients with type Ia glycogen storage disease: a single-centre retrospective study and a review of literature

Na Xu et al. Arthritis Res Ther. .

Abstract

Background: This study aimed to explore the clinical features of gout in adult patients with glycogen storage disease type Ia (GSD Ia).

Methods: Ninety-five adult patients with GSD Ia admitted to Peking Union Medical College Hospital were retrospectively analysed. A clinical diagnosis of GSD Ia was confirmed in all patients through gene sequencing. All patients had hyperuricaemia; 31 patients complicated with gout were enrolled, and 64 adult GSD Ia patients with asymptomatic hyperuricaemia were selected as a control group during the same period. Clinical characteristics were analysed and compared between the two groups.

Results: Thirty-one of the 95 patients had complications of gout (median age, 25 years; 11 (35.5%) females). All 31 patients had hepatomegaly, abnormal liver function, fasting hypoglycaemia, hyperuricaemia, hyperlipaemia, and hyperlacticaemia. A protuberant abdomen, growth retardation, recurrent epistaxis, and diarrhoea were the most common clinical manifestations. Among these 31 patients, 10 patients (32.3%) had gout as the presenting manifestation and were diagnosed with GSD Ia at a median time of 5 years (range, 1-14) after the first gout flare. The median age of gout onset was 18 years (range, 10-29). Fifteen of the 31 GSD Ia-related gout patients were complicated with gouty tophi, which has an average incidence time of 2 years after the first gouty flare. The mean value of the maximum serum uric acid (SUA) was 800.5 μmol/L (range, 468-1068). The incidence of gout in adult GSD Ia patients was significantly associated with the initial age of regular treatment with raw corn starch, the proportion of urate-lowering therapy initiated during the asymptomatic hyperuricaemic stage, maximum SUA level, and mean cholesterol level.

Conclusions: Determination of GSD Ia should be performed for young-onset gout patients with an early occurrence of gouty tophi, especially in patients with hepatomegaly, recurrent hypoglycaemia, or growth retardation. Early detection and long-term regulatory management of hyperuricaemia, in addition to early raw corn starch and lifestyle intervention, should be emphasized for GSD Ia patients in order to maintain good metabolic control.

Trial registration: Retrospectively registered.

Keywords: Glycogen storage disease; Gout; Hyperuricaemia; Type Ia.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of the patients included in the study. GSD, glycogen storage disease; GSD Ia, glycogen storage disease type Ia
Fig. 2
Fig. 2
Clinical features of adult patients with GSD Ia. GSD Ia, glycogen storage disease type Ia
Fig. 3
Fig. 3
Age distribution of gout onset in patients with glycogen storage disease type Ia
See this image and copyright information in PMC

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