Abstract

REVIEW ON MONOSODIUM URATE CRYSTALS: CULPRIT OF GOUT

Akshay D. Tuljapure*, Aditya A. Bogar, Priyanka A. Shelke, Suchita P. Ramteke, Anjali U. Navande, Amruta A. Hajare and Vinayak B. Jamkar

ABSTRACT

Gout is a rheumatic disorder characterised by the deposition of monosodium urate (MSU) crystals in the joints, which is due to the high serum uric acid level present in the blood. A high SUA level is a characteristic feature of hyperuricemia. The increased level of uric acid is due to increased hepatic metabolism and decreased uric acid excretion. Due to the increased level of uric acid, monosodium urate monohydrate (NaC5H3N4O3.H2O) crystals are formed. MSU crystals have a triclinic structure, with stacked sheets of purine rings forming the needle-shaped crystals seen under the microscope. This MSU crystal plays a major role in the development of acute and chronic inflammatory gout. It is very important to diagnose and treat gouty arthritis; however, various diagnostic methods such as polarising light microscopy, dual energy computed tomography (DECT), ultrasonography (US), and the urine test were performed. NSAIDs are used in inflammatory gout, whereas xanthine oxidase inhibitors and uricosuric substances inhibit crystal formation by decreasing the uric acid level. The single diffusion gel technique and wet chemical precipitation technique are generally used for the in vitro synthesis of MSU crystals. Whereas FTIR, powder XRD, and TGA are used for the characterization of MSU crystals. The present review was focused on epidemiology, the role of MSU crystals in the progression of gout, its diagnosis and treatment, and its in vitro synthesis and characterization.

Keywords: Gout, Hyperuricemia, Monosodium urate monohydrate crystals, Ultasonography, NSAIDs, xanthine oxidase inhibitors.