Identifying Aspirin as a Contributing Factor to Persistent Gout: A Case Report

Gout is a metabolic disorder characterized by acute and chronic inflammatory responses due to monosodium urate (MSU) crystal deposition, commonly affecting the first metatarsophalangeal joint, hands, and/or knees. While this condition is typically self-limiting, recurrent cases can suggest an underlying contributor. Low-dose aspirin is commonly used as a cardiovascular prophylaxis. Although research is limited, aspirin has been implicated in decreased uric acid excretion, thus potentially exacerbating gout symptoms in patients. This case highlights a 67-year-old African American male who presented to a clinic complaining of gout in his right hand. Despite following strict lifestyle practices and medication compliance, pharmacological therapies were rendered ineffective until aspirin was identified as a contributing factor to his gout. Optimizing his medication regimen resolved his gout attacks, which stresses the concept that clinicians must be diligent with lesser-known side effects of medication to improve patient outcomes.