POS1127 ULTRASOUND ASSESSMENT OF GOUT LESIONS IN AN ALGERIAN POPULATION WITH ASYMPTOMATIC HYPERURICEMIA

Background:Hyperuricemia is a common biological abnormality, often clinically asymptomatic. However, it can announce a gout and be linked to many diseases such as metabolic syndrome, high blood pressure or kidney disease.In fact, the majority of learned societies do not recommend any urate lowering therapy (ULT) as long as the hyperuricemia remains asymptomatic. But it turns out that part of the population with asymptomatic hyperuricemia (AH) develops a gout after a few years particularly with genetic predisposition, but also on certain risk factors that need to be confirmed.By this way, musculoskeletal ultrasound (MUS) can detect “asymptomatic gout” by visualizing signs of urate deposits (UD) in subjects with AH.Objectives:Our main objective is already to estimate the prevalence of specific signs of gout in Algerian population with AH and assess the factors exposing to UD.Methods:This is a descriptive cross-sectional study from January 2017 to February 2019, with the recruitment of subjects with AH and serum urate level > 60 mg / L, who do not take any ULT and have not associated any chronic inflammatory rheumatism, where we performed a MUS of the knees, metatarsophalangeal joints MTP1, MTP2 and metacarpophalangeal joint MCP2 and MCP3 with the Achilles, patellar and quadricipital tendons.Results:We retained 258 subjects with AH, 132 women and 126 men (sex ratio = 0.95), the mean age was 59 years, the mean body mass index (BMI) was 28.4 kg / m2, 42 patients were under diuretics, 37 patients reported being on low-dose of aspirin 100 mg daily.The mean rate of serum urate levels was 78 ± 10 mg / L, the prevalence of UD found at the MUS was 22% (n = 58), among them 36 % (21/58) had a sign of the double contour DC on the MTP1 and 29% (17/58) on the knee, 7% (4/58) had tophi on the MTP1 and 3% (2/58) had urate aggregates. The factors reported to be linked to UD in the sample were: the male gender (p = 0.0016); the high uric acid level (p= 0.0355); BMI (p = 0.0427); taking diuretics for women (p= 0.0002).Conclusion:Through this work, it is clear that elementary ultrasound lesions related to gout disease are common in a population with AH and concerned one fifth of subjects in our study with a higher risk in men and subjects with obesity and high uric acid level, but also in women taking diuretics. These results need to be enhanced with a randomized controlled study in order to better determine the predisposing factors for gout in any subject with AH.Disclosure of Interests:None declared.

Gambaran Kadar Asam Urat pada Pasien Infark Miokard Akut di RSUP Prof. Dr. R. D. Kandou Manado Periode September 2016 – Agustus 2017

Acute myocardial infarction (AMI) is a cardiovascular disease that becomes one of the leading causes of death worldwide. Rupture of atherosclerotic plaque followed by thrombus formation and occlusion of coronary arteries causes an acute decrease in the blood supply to some parts of myocardium resulting in myocardial infarction, associated with inflammatory responses that may cause increased uric acid level. Patients of myocardial infarction accompanied by high uric acid level have higher mortality rate. This study was aimed to determine the description of uric acid level in patients with AMI at Prof. Dr. R. D. Kandou Hospital Manado. This was a retrospective descriptive study using medical record data of patients with AMI hospitalized at Prof. Dr. R. D. Kandou Hospital Manado in the period of September 2016 until August 2017. The results showed 92 AMI cases (60.1%) who had elevated uric acid level. The majority of AMI cases were males (115 patients; 75.2%), aged 51-60 years old, (52 patients; 34%), Minahasan ethnic (138 cases; 90.2%), and had no family history of high uric acid level (24 cases; 15.7%). Conclusion: The majority of the patients with AMI had elevated uric acid level.Keywords: acute myocardial infarction, uric acid, inflammatory response. Abstrak: Infark miokard akut (IMA) merupakan penyakit kardiovaskular yang menjadi salah satu penyebab kematian di dunia. Pecahnya plak aterosklerosis dengan pembentukan trombus dan oklusi pembuluh koroner menyebabkan penurunan pasokan darah secara akut ke sebagian miokardium sehingga terjadi infark miokard, diikuti respon inflamasi yang menyebabkan asam urat meningkat. Pada pasien IMA dengan kadar asam urat tinggi dapat terjadi peningkatan angka kematian. Penelitian ini bertujuan untuk mengetahui gambaran kadar asam urat pada pasien IMA di RSUP Prof. Dr. R. D. Kandou Manado periode September 2016 sampai Agustus 2017. Jenis penelitian ialah deskriptif retrospektif menggunakan data rekam medik pasien IMA yang dirawat di RSUP Prof. Dr. R. D. Kandou Manado periode September 2016 sampai Agustus 2017. Hasil penelitian memperlihatkan 92 kasus IMA (60,1%) memiliki kadar asam urat meningkat. Mayoritas kasus IMA berjenis kelamin laki-laki (115 pasien; 75,2%), usia 51-60 tahun (52 pasien; 34%), suku Minahasa (138 pasien; 90,2%), dan tidak memiliki riwayat keluarga asam urat (24 pasien; 15,7%). Simpulan: Sebagian besar pasien dengan IMA memiliki kadar asam urat yang meningkat.Kata kunci: infark miokard akut, asam urat, respon inflamasi