Khanna · Journal of clinical medicine 2020 · narrative review · n=?

Systemic Urate Deposition: An Unrecognized Complication of Gout?

Cited 66 times in the scientific literature.

Level 5 - mechanism / opinion, no new human data

Narrative literature review synthesizing autopsy, histopathology, surgical, and imaging findings without systematic search or meta-analytic methodology.

PubMed 33023045 · doi:10.3390/jcm9103204 · record verified 2026-08-27

What was done

The authors conducted a narrative review of published literature detailing extra-articular monosodium urate crystal deposition identified via autopsy, histopathology, surgical findings, and advanced imaging modalities such as dual-energy computed tomography (DECT). Organs and tissues evaluated included the heart, blood vessels, kidneys, spine, eyes, skin, and gastrointestinal system.

What was found

The abstract reports no quantitative pooled metrics or sample sizes. It notes that extra-articular urate deposition occurs in vascular, cardiac, renal, spinal, ocular, and gastrointestinal tissues rather than being strictly confined to joints and subcutaneous tophi.

Why it matters

Recognizing extra-articular urate accumulation demonstrates that gout is a systemic crystal deposition disorder, supporting guidelines that recommend lowering serum urate below 6 mg/dL to prevent broader tissue complications.

Limits

The abstract provides no quantitative data, search methodology, inclusion criteria, or study counts. The clinical and prognostic significance of asymptomatic extra-articular urate deposits remains unproven, and whether reducing these deposits improves cardiovascular or survival outcomes requires prospective interventional trials.

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