Serum Uric Acid as an Inflammatory Marker in Adult Sudanese Patients with Systemic Autoimmune Rheumatic Diseases (Khartoum Rheumatology Clinics, 2022–2023)

Ziryab Imad Taha Mahmoud¹, Fatima Moneer2, Yassin Abdelrahim Abdalla 3, Tarig Alhadi Madibbo Ahmed4 , Salih Boushra Hamza⁵ , Hadia Abdelbagi Alhade6

Abstract

Backgroung Systemic autoimmune rheumatic diseases (SARDs) are chronic inflammatory disorders affecting the musculoskeletal system and multiple organs. Inflammation is usually assessed using erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), but serum uric acid (UA) may also reflect systemic inflammation beyond gout-related pathology. Objective: To determine the frequency of hyperuricemia among adult Sudanese patients with SARDs and evaluate its relationship with ESR and CRP.

Methods: A descriptive cross-sectional study was conducted in rheumatology clinics in Khartoum State, Sudan (August 2022–March 2023). Adults with systemic rheumatic diseases (n=130) were enrolled. Clinical and laboratory data (ESR, CRP, UA) were extracted from questionnaires and medical records. Associations were tested using chi-square and t-tests, and correlations were assessed using Pearson’s correlation (p<0.05). Results: Participants were predominantly female (59.2%), and 80.6% were aged 18–65 years. SLE (39.5%) and RA (31.5%) were the most frequent diagnoses, followed by undifferentiated connective tissue disease (15.3%) and ankylosing spondylitis (6.1%). ESR was elevated in 93% and CRP was positive in 34%. Serum UA was elevated in 61% of patients. High ESR was associated with SLE (p≈0.04), while high CRP was associated with SLE (p≈0.01) and ankylosing spondylitis (p≈0.03). In SLE, UA correlated with ESR and CRP (p<0.005 each). In RA, UA and CRP were elevated (p=0.002) and UA correlated with CRP. UA also correlated with CRP in undifferentiated connective tissue disease (p<0.001). Conclusion: Hyperuricemia was common among Sudanese adults with SARDs and showed significant relationships with conventional inflammatory markers in key subgroups. UA is an inexpensive, widely available test that may complement ESR and CRP for inflammation assessment in resource-limited settings; larger multicenter studies are warranted to confirm clinical applicability.