M10.219

Clinical Causes: Use of certain medications such as diuretics (water pills) which increase uric acid levels. Immunosuppressive drugs prescribed for autoimmune conditions or after organ transplants. Chemotherapy drugs that can interfere with uric acid processing. Medications containing high levels of purines or other substances that promote uric acid buildup. Rapid weight loss or fasting, which may contribute to increased uric acid levels when combined with medication use.

Key Symptoms: Sudden onset of pain in the affected shoulder, often severe. Swelling and tenderness around the shoulder joint. Redness and warmth over the joint area. Limited range of motion due to pain and swelling. Possible formation of tophi, which are deposits of uric acid crystals under the skin, around the joint.

Diagnosis Path: Diagnosing drug-induced gout involves a combination of clinical assessment and laboratory tests. Healthcare providers typically review the patient’s medication history and symptoms. To confirm the diagnosis, they may perform joint fluid analysis, where a sample is taken from the shoulder joint and examined for uric acid crystals. Blood tests measuring serum uric acid levels can also support the diagnosis, although levels may vary during an attack. Imaging tests like ultrasound or X-rays might be used to assess joint damage and rule out other causes of shoulder pain.

Treatment Protocols: Discontinuing or adjusting medications that contribute to uric acid buildup under medical supervision. Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation. Colchicine, used to decrease inflammation during acute attacks. Corticosteroids, which can be administered orally or via injection for inflammation control. Lifestyle modifications such as staying well-hydrated, avoiding purine-rich foods, and maintaining a healthy weight. Long-term urate-lowering therapy for chronic management if recurrent gout attacks occur, including medications like allopurinol or febuxostat.