Gout, Urate, and Crystal Deposition Disease

28 pages, 2265 KB

Open AccessReview

Non-Hyperuricemia Experimental Models of Gout

by Yevetta Xiang, An-Tzu Chien and Christopher Hall

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 8; https://doi.org/10.3390/gucdd4010008 - 16 Mar 2026

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Gout is the most common form of inflammatory arthritis in men, driven by hyperuricemia and the deposition of monosodium urate (MSU) crystals. The innate immune response to these crystals leads to acute inflammatory episodes, called flares, characterized by intense joint pain, swelling, and [...] Read more.

Gout is the most common form of inflammatory arthritis in men, driven by hyperuricemia and the deposition of monosodium urate (MSU) crystals. The innate immune response to these crystals leads to acute inflammatory episodes, called flares, characterized by intense joint pain, swelling, and temporary disability. Although gout flares are self-limiting, they impose a considerable burden on patients’ quality of life and contribute to increased healthcare utilization. A detailed understanding of the inflammatory processes triggered by MSU crystals is critical for developing targeted therapies to prevent and manage flares effectively. This review provides an overview of experimental models used to study the inflammatory phase of gout, with a focus on both in vivo and in vitro models of MSU crystal-induced inflammation. We concentrate on models that reproduce the acute inflammatory response following MSU crystal deposition, including the air pouch, intraarticular injection, and peritonitis rodent models, alongside the larval zebrafish model. In addition, we discuss in vitro approaches using primary immune cells and cell lines. We discuss the strengths, limitations, and translational relevance of these models and highlight some examples of how they have contributed to our understanding of the etiology of gout. Of note, models of hyperuricemia are not included here as these have been extensively reviewed elsewhere. Full article

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14 pages, 964 KB

Open AccessReview

Irregular Gout, Asymptomatic Hyperuricaemia and the Role of Treatment

by Dorian O. Haskard

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 7; https://doi.org/10.3390/gucdd4010007 - 11 Mar 2026

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Abstract

‘Irregular gout’ is an obsolete term that was used in the past to describe both trivial and serious health issues seemingly related to gouty arthritis. This article looks back at what physicians such as George Cheyne, William Oliver, William Cullen and William Heberden [...] Read more.

‘Irregular gout’ is an obsolete term that was used in the past to describe both trivial and serious health issues seemingly related to gouty arthritis. This article looks back at what physicians such as George Cheyne, William Oliver, William Cullen and William Heberden thought about ‘irregular gout’. It examines to what degree the concept is still relevant, knowing what we now know about uric acid and the local and systemic inflammatory effects of urate crystal formation. In parallel, the article traces the trajectory from Cullen’s ‘asthenic gout’ to nineteenth century ‘uric acid poisoning’ and thence to possible hidden consequences of asymptomatic hyperuricaemia. ‘Irregular gout’ in its various guises has greatly influenced both orthodox and unorthodox treatments over the years. Although the term is no longer used, the concept is by no means dead. Full article

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36 pages, 951 KB

Open AccessConference Report

2025 Joint Ectopic Calcification Meeting (JECM)—Abstract Proceedings

by Hervé Kempf, Karolien Aelbrecht, Sarah Beck-Cormier, Georges Lefthériotis, Lukas Nollet, Flora Szeri, Andras Varadi and Olivier M. Vanakker

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 6; https://doi.org/10.3390/gucdd4010006 - 10 Mar 2026

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Abstract

The 1st Joint Ectopic Calcification Meeting (JECM) was held in Nancy, France on 24–26 September 2025. In response to the growing need for unified scientific dialogue on soft tissue ectopic calcification, the Joint Ectopic Calcification Meeting (JECM) brought together the communities of INTEC, [...] Read more.

The 1st Joint Ectopic Calcification Meeting (JECM) was held in Nancy, France on 24–26 September 2025. In response to the growing need for unified scientific dialogue on soft tissue ectopic calcification, the Joint Ectopic Calcification Meeting (JECM) brought together the communities of INTEC, ISSEC, BBC, iSCCa, and the PXE Budapest meeting. This initiative emerged from concerns over fragmentation in the field, with multiple smaller meetings diluting collaborative potential. By consolidating efforts, JECM aims to foster interdisciplinary exchange, highlight cutting-edge research, and build a flagship event for the ectopic calcification community. With over 100 participants, the inaugural meeting in Nancy marks a promising step toward a more integrated and dynamic future for the field. The abstracts of this year’s meeting oral and poster presentations are collected in this conference paper, with permission from the corresponding authors. Full article

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21 pages, 426 KB

Open AccessReview

Allopurinol-Related Severe Cutaneous Adverse Reactions: A Narrative Review

by Edoardo Cipolletta, Satveer K. Mahil, Catherine H. Smith and Abhishek Abhishek

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 5; https://doi.org/10.3390/gucdd4010005 - 27 Feb 2026

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Abstract

Allopurinol, the most used urate-lowering drug for the treatment of gout, is associated with rare but life-threatening severe cutaneous adverse reactions (SCARs) such as Stevens–Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, but not [...] Read more.

Allopurinol, the most used urate-lowering drug for the treatment of gout, is associated with rare but life-threatening severe cutaneous adverse reactions (SCARs) such as Stevens–Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), and Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) syndrome, but not Acute Generalised Exanthematous Pustulosis (AGEP). They are characterised by severe skin and systemic involvement and are associated with substantial morbidity and a high risk of mortality. This narrative review summarises evidence on the clinical presentation, epidemiology, risk factors, and preventive strategies for allopurinol-induced SCARs. Key risk factors include the presence of the HLA-B*58:01 allele, renal impairment, older age, female sex, heart disease, higher starting doses of allopurinol, and certain ethnicities, e.g., South Asian, Han Chinese, and African populations likely due to the higher prevalence of the HLA-B*58:01 allele. Risk mitigation strategies include genetic testing for HLA-B*58:01 in high-risk ethnic groups and avoiding allopurinol in those that are positive for the HLA-B*58:01 allele, starting allopurinol at a low-dose (e.g., 50–100 mg/day) and up-titrating it gradually at 4-week intervals, and avoiding high-dose allopurinol in those with risk factors (e.g., chronic kidney disease stage ≥3). In addition, risk stratification using prediction tools may enable a safer use of allopurinol. Full article

2 pages, 157 KB

Open AccessBook Review

Book Review: Haskard, D. The Gout: A Medical Microcosm in a Changing World; World Scientific Publishing Europe Ltd.: London, UK, 2025; ISBN: 978-1-80061-650-9

by Geraldine M. McCarthy

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 4; https://doi.org/10.3390/gucdd4010004 - 27 Feb 2026

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Abstract

When, as a junior doctor, Dorian Haskard made a presentation on a patient with gout to the Medical Staff Round at the London Hospital in 1981, he was told that gout was ‘yesterday’s disease and academically dead’ [...] Full article

49 pages, 11232 KB

Open AccessConference Report

Gout, Hyperuricemia and Crystal-Associated Disease Network (G–CAN) Conference 2025: Early-Career Investigators’ Abstracts

by Gout, Hyperuricemia and Crystal-Associated Disease Network

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 3; https://doi.org/10.3390/gucdd4010003 - 27 Jan 2026

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Abstract

The eleventh annual international G–CAN research symposium was held in Chicago, IL, on the 22nd and 23rd of October 2025. This hybrid meeting, a live face-to-face and virtual live symposium, was attended by 198 participants. Twenty-five research abstract submissions were received from early-career [...] Read more.

The eleventh annual international G–CAN research symposium was held in Chicago, IL, on the 22nd and 23rd of October 2025. This hybrid meeting, a live face-to-face and virtual live symposium, was attended by 198 participants. Twenty-five research abstract submissions were received from early-career investigators for plenary oral and brief oral presentations. Here, we present the 24 accepted, lightly edited abstracts from the early-career presenters consenting to have their materials published. We thank and congratulate the presenters for their work and contributions to the meeting. Full article

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9 pages, 783 KB

Open AccessReview

The Utility of Ultrasound-Guided Synovial Biopsy in the Diagnosis of Crystal-Induced Arthritis

by Arthur M. Mandelin II, Diane Lewis Horowitz, Darren Tabechian and Ami Ben-Artzi

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 2; https://doi.org/10.3390/gucdd4010002 - 27 Jan 2026

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Abstract

The diagnosis of crystal-induced arthritis is routinely established by synovial fluid analysis. However, a synovial effusion is not always present, fluid aspiration is not always possible or practical, and synovial fluid analysis is occasionally subject to false negative results. When there is a [...] Read more.

The diagnosis of crystal-induced arthritis is routinely established by synovial fluid analysis. However, a synovial effusion is not always present, fluid aspiration is not always possible or practical, and synovial fluid analysis is occasionally subject to false negative results. When there is a high suspicion of crystal-induced arthritis, but crystals are not identified in the synovial fluid, a biopsy of the synovium in search of crystals can assist in making a diagnosis. In this manuscript, we review the utility of ultrasound-guided needle biopsy of synovial tissue in the identification of crystal-induced arthritis, briefly describe the procedure, and recommend best practices for specimen handling and tissue processing. Full article

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16 pages, 1587 KB

Open AccessConference Report

The 16th European Crystal Network (ECN) Workshop—2025 ECN Abstract Proceedings

by Frédéric Lioté, Fernando Perez-Ruiz, Hang-Korng Ea, Tony Merriman, Tristan Pascart and Alexander So

Gout Urate Cryst. Depos. Dis. 2026, 4(1), 1; https://doi.org/10.3390/gucdd4010001 - 31 Dec 2025

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Abstract

For the 16th Anniversary this year, the ECN workshop is again held in downtown Paris. Every year the ECN workshop offers a unique opportunity for clinicians and researchers interested in crystals, inflammation, and crystal-induced diseases, including gout, to present their latest results [...] Read more.

For the 16th Anniversary this year, the ECN workshop is again held in downtown Paris. Every year the ECN workshop offers a unique opportunity for clinicians and researchers interested in crystals, inflammation, and crystal-induced diseases, including gout, to present their latest results and discuss novel concepts. Full article

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Gout Urate Cryst. Depos. Dis., Volume 4, Issue 1 (March 2026) – 8 articles

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