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Review
, 126 (5), 450.e1-8

Saturnine Gout, Redux: A Review

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Review

Saturnine Gout, Redux: A Review

Sam R Dalvi et al. Am J Med.

Abstract

Illicitly distilled beverages (colloquially referred to as moonshine) account for approximately one third of alcohol consumption worldwide. Moonshine is often produced in makeshift distilling units composed of old, repurposed parts, whose component elements can leach into the distillate. Consequently, the resultant beverages may inadvertently contain harmful toxins, one of which is the metal lead. One manifestation of chronic lead toxicity-from moonshine or other forms of chronic lead poisoning-is the rheumatologic entity known as saturnine gout. With the increasing prevalence of gout over the past few decades, physicians should be aware of the association of moonshine consumption or lead toxicity with gouty arthritis. In this article, we present an overview of saturnine gout, beginning with a discussion of lead poisoning in antiquity and tracing its path to modern times. The contribution of lead to human disease and the clinical features of saturnine gout are outlined. After describing the role of lead in renal insufficiency and purine metabolism, we conclude with a discussion of specific strategies to manage this clinically important form of secondary gout.

Comment in

  • Unrecorded alcohol and lead poisoning.
    Rehm J, Lachenmeier DW. Rehm J, et al. Am J Med. 2013 Dec;126(12):e39. doi: 10.1016/j.amjmed.2013.05.019. Am J Med. 2013. PMID: 24262744 No abstract available.
  • The reply.
    Dalvi SR, Pillinger M. Dalvi SR, et al. Am J Med. 2013 Dec;126(12):e41. doi: 10.1016/j.amjmed.2013.08.008. Am J Med. 2013. PMID: 24262745 No abstract available.

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