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Normal uric acid during flare

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1 studies · 1 recommendation

Last updated: January 29, 2026

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Normal uric acid levels during a gout attack do not rule out gout

A significant proportion of patients experiencing acute gout attacks have normal serum uric acid levels at the time of the flare. This means patients should not assume they do not have gout simply because a blood test shows normal uric acid during an attack. The diagnosis of gout requires clinical assessment beyond just uric acid levels.

Evidence

Are serum uric acid levels always elevated in acute gout?

Authors: Fletcher, Adelaide, Leiszler, Matt, Poddar, Sourav

Published: January 1, 2011

This systematic review of prospective cohort studies found that 11% to 49% of patients with acute gout present with normal serum uric acid levels during their attacks (SOR: A, based on prospective cohort studies). Patients taking allopurinol were significantly more likely to have normal uric acid levels during acute gout episodes compared to those not on urate-lowering therapy (SOR: B, extrapolated from prospective cohorts). These findings demonstrate that serum uric acid testing during an acute attack has limited diagnostic utility and normal results should not be used to exclude gout.

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