Acute gout attack with normal serum uric acid levels.

Aim: The paper aims to determine the prevalence of clinical cases with acute gout attacks and normal serum uric acid levels. Material and methods: This retrospective study was conducted between October, 2013 and June, 2014 in 30 patients diagnosed with acute gout attack admitted to the Ist Clinic of Rheumatology of Iasi. The diagnosis was based on clinical manifestations and positive response to therapeutic test with colchicine. Results: Normal serum uric acid levels were found in 63.3% of the patients with acute gout attack. The inflammatory syndrome was detected in 76.6% of patients with high erythrocyte sedimentation rate (ESR) levels and in 30% of patients who had elevated C-reactive protein levels. The urinary excretion of uric acid was measured in 11 patients and it was found increased in 55% of them. Conclusions:  The diagnosis of acute gout attack should not be excluded in the presence of normal serum uric acid levels if the clinical manifestations or the positive response at colchicine are suggestive of gout. The low uric acid level is correlated with increased inflammatory factors and urinary excretion of uric acid.