GOUT IN PATIENTS ATTENDING THE RHEUMATOLOGY UNIT OF LOME HOSPITAL

A retrospective study was carried out to determine the semiological and aetiological profiles of gout in patients attending a hospital clinic in Lome, Togo. Gout was diagnosed in 106 of the 3517 patients seen from October 1989 through October 1993. Clinical findings and hyperuricaemia were the basis for the diagnosis of gout in 88 patients. In the remaining 18 patients, monosodium urate crystals were demonstrated in synovial fluid in addition. One hundred and five patients were male. The mean age at disease onset was 45 yr and the mean duration of the disease was 8 yr. Twenty patients (19%) had tophi. None of the patients had a history of renal colic. The ankle, the knee and the first metatarsophalangeal joint were the joints most often affected. Sixty-three patients (59%) had a monoarticular involvement, whereas an oligo- or polyarticular involvement was observed in the remaining 43 patients. Twelve patients (11%) had a familial history of gout. Forty patients (38%) were obese and 78 (74%) were habitual drinkers. Forty-one patients (39%) had hypertension and 17 of them were under diuretic therapy. While more work is needed before drawing a definite conclusion, this study is in striking contradiction with the common belief that gout is exceedingly rare in Black Africa. The risk factors in Togo seem to be no different from those observed in Caucasians.