Therefore, food intake accounts for about 450 mg of uric acid daily. Hyperuricemia and gout are common complications in patients receiving cyclosporine for organ transplants. Symptoms and Signs Acute gouty arthritis starts without warning. Acute monarticular or, less often, polyarticular pain, often nocturnal, is usually the first symptom. The pain becomes progressively more severe and is often excruciating.
Signs resemble an acute infection, with swelling, warmth, redness, and exquisite tenderness.
The overlying skin is tense, warm, shiny, and red or purplish. Fever, tachycardia, chills, malaise, and leukocytosis may occur. The first few attacks usually affect only a single joint and last only a few days, but later attacks may affect several joints simultaneously or sequentially and persist for weeks if untreated. Local symptoms and signs eventually regress, and normal joint function returns. Asymptomatic intervals vary but tend to become shorter as the disease progresses.