LAUSR

Background The incidence of gout in China is increasing in adults as well as children. The clinical manifestations of juvenile gout are not well described due to the limited number of cases in the past. Delineating the features of adult and juvenile gout may help pediatric providers recognize gout more effectively. Objectives We aim to describe and compare the clinical characteristic of adults and children with gout. Methods A total of 51 juvenile gout patients (age ≤ 18 years) and 337 adult gout patients in our hospital from Jan 2016 to Dec 2018 were enrolled in the study. Clinical parameters and laboratory data of the 2 groups were analyzed. Results The average age of onset in children with gout was 15.0±1.9 years and the youngest patient was 8 years old. Compared to the adult group, juvenile gout patients displayed lower BMI (23.0±3.8 vs. 25.6±3.5 kg/m2, P<0.001) but higher serum uric acid levels (9.98±2.65 vs. 8.09±2.47 mg/dL, P<0.001). Interestingly, systemic inflammation was less prominent in children compared to adult as illustrated by lower C-reactive protein levels (7.1±13.5 vs. 23.7±40.7 mg/L, P=0.004) and lower erythrocyte sedimentation rate (12.7±12.9 vs. 33.1±34.2 mm/hr, P<0.001). Renal function impairment was rare in children compared to adults (serum creatinine 98.73±19.04 vs 120.38±34.58 μmol/L, P<0.001). In terms joint manifestations, juvenile gout was associated with greater finger joint involvement (23.53% vs. 6.82%, P<0.001) and less knee involvement (11.76% vs. 41.84%, P<0.001) compared to adults. Ankle involvement was slightly more common in the pediatric group (49.02% vs. 30.56% in adults, P=0.009) while MTP was similarly affected (50.98% vs. 32.94%, P=0.012). In addition, tophi was found in four cases (7.8%) in the juvenile group compared to 113 cases in adults (33.5%), suggesting that although less common, advanced features of gout can also occur in children. Conclusion Juvenile gout is associated with higher serum uric acid levels and greater involvement of finger joints. Correlations with BMI and systemic inflammation were less prominent compared to gout in adults. These findings will help clinicians better recognize gout in children. References [1] Chen, S.Y. and M.L. Shen, Juvenile gout in Taiwan associated with family history and overweight. J Rheumatol, 2007. 34(11): p.2308-11. [2] Lu, C.C., et al., Clinical characteristics of and relationship between metabolic components and renal function among patients with early-onset juvenile tophaceous gout. J Rheumatol, 2014. 41(9): p.1878-83. Disclosure of Interests None declared