Can serum urate levels be used to diagnose gout?
Serum urate levels alone cannot be used to diagnose gout. Although serum urate levels are elevated (>6.8 mg/dL) at some time in almost all gout patients, serum concentrations are normal at the time of an acute flare in up to one-third (false-negative results). This appears to be in part due to interleukin (IL)-6 generation, which exerts a uricosuric effect. It is equally important to recognize that many individuals may have hyperuricemia in the absence of gout (false-positive results).