Gout & Systemic Lupus Erythematosus

Gout is caused by elevated uric acid levels leading to urate crystal deposition in joints, classically causing sudden, severe pain, redness, and swelling in a single joint — most classically the first metatarsophalangeal joint (the base of the big toe), a presentation called podagra. Acute attacks are managed with NSAIDs, colchicine, or corticosteroids (not typically with urate-lowering medications, which are used for long-term prevention and can actually worsen an acute attack if started during one); once an acute attack resolves, urate-lowering therapy (such as allopurinol) may be started for long-term prevention in patients with recurrent attacks. Dietary teaching focuses on limiting purine-rich foods (organ meats, certain seafood, red meat) and alcohol (particularly beer), along with adequate hydration, since concentrated urine promotes crystal formation.