Hyperuricaemia is a higher than normal blood level of uric acid. There are individuals with high blood uric acid levels and have never had an attack of gout. Are these people at risk of arthritis of the joints and kidney stones from urate crystals deposits? Yes they are.

Firstly the diagnosis of asymptomatic hyperuricaemia is made more frequently because of more screening, and blood tests for insurance purposes. Secondly you can break it down to primary and secondary types. In the primary type there may be a genetic link. In this case there is a deficiency of an important enzyme leading to excess production of uric acid. When this is severe (Lesch-Nyhan Syndrome), there are severe problems.

Secondary hyperuricaemia results from factors affecting the production and/or elimination of uric acid. These include medical conditions, drugs, metabolic conditions, obesity and alcohol consumption.

Sometimes hyperuricaemia is suspected when patients present to the doctor with tophi. These can be acute or chronic. An acute tophus is usually small and later soften when it becomes chronic. They look like small nodules and as they grow bigger, the skin overlying them looks shiny and feels smooth. Sometimes they can ulcerate and release white chalky stuff. If the patient is treated with allopurinol the tophi usually becomes smaller.

Dr. Phil Hariram

Arthritis Guide.