Saturnine gout (saturnus = lead) refers to the development of hyperuricemia and gout secondary to lead poisoning.
Lead is toxic to renal tubular cells and can induce acute or chronic renal failure. It impairs excretion of uric acid into the urine. It can also alter purine metabolism.
Risk factors:
(1) drinking moonshine, which may be contaminated with lead
(2) heavy occupational exposure to lead
(3) therapy with drugs that interfere with uric acid excretion
(4) alcohol abuse
(5) cooking or eating with pewter utensils or containers
A patient with lead poisoning can develop bone and joint pain independent of hyperuriciemia. Still, a patient with lead poisoning and joint pains should be screened for gout.
A patient with gout and risk factors for lead poisoning should be screened for lead poisoning.
The differential diagnosis includes the occurrence of gout in a person with low level lead poisoning, where the lead poisoning and gout are independent of each other.
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