The role of high large unstained cell percentages in ongoing inflammation in the intercritical gout

Abstract

Objectives: This study aims to investigate whether large unstained cells (LUCs) is a marker of inflammation in gout patients and whether it is associated with different clinical conditions such as erosion, tophus, intercritical period, and gout flare.

Patients and methods: Between November 2022 and May 2023, a total of 100 consecutive adult gout patients (81 males, 19 females; mean age 53.8±12.8 years; range, 21 to 79 years) and 30 healthy controls (24 males, 6 females; mean age 57.2±10.6 years; range, 28 to 75) were included in this cross-sectional study. Data including demographics, clinical characteristics, laboratory results and direct radiography images of affected joints at the most recent visit were recorded.

Results: Leukocyte counts were found to be significantly higher in gout patients (p=0.048). The LUC counts and percentages and levels of acute phase reactants were similar between the patient and control groups (p=0.401, p=0.668, p=0.222, and p=0.505, respectively). In subgroup analyses of the gout patients, there were no significant differences in LUC counts and percentages between those with tophaceous disease (p=0.650 and p=0.388, respectively), erosions (p=0.154 and p=0.137, respectively) and elevated serum uric acid levels (p=0.918 and p=0.196, respectively). However, LUC percentages were statistically significantly higher in patients without elevated C-reactive protein (CRP) and in the intercritical gout (p=0.039 and p=0.05, respectively).

Conclusion: Our study results showed similar LUC counts and percentages between the gout patients and healthy controls. However, in the subgroup analysis of the gout patients, the LUC percentages were observed to be significantly higher in those without high CRP levels and in patients with intercritical gout. This finding may suggest that subclinical inflammation persists in intercritical gout.