⚠Due to planned maintenance you will experience short (<30 min) downtime between 08:00 - 08:30 CET.
Condition
Gout is a type of inflammatory arthritis caused by the accumulation of uric acid crystals in the joints, resulting from high blood levels of uric acid (hyperuricemia). These crystal deposits trigger painful flare-ups of inflammation in and around the affected joints, which typically last for a week or two before resolving.
Individual at risk
Donor
Guidance at RECRUITMENT
ACCEPTABLE
Guidance at CT/WORK-UP
ACCEPTABLE for bone marrow donation
ACCEPTABLE for PBSC if mild disease, following individual risk assessment. PBSC donors should be counseled on the risk of gout exacerbation due to GCSF, to be aware of and accepting of potential risk (consent).
If donor has gout and is HLA- B58:01, consider informing donor and their family healthcare professional in case they are considering allopurinol in future because this allele is strongly associated with severe cutaneous adverse reactions to allopurinol. This allele is found in approximately 10-15% of Han Chinese, 6-8% Thais, 1-2% Europeans and Japanese.
Justification for guidance
Gout is not a life-threatening disease and can be managed with medication or conservative therapies. There have been several anecdotal reports of severe exacerbations of gout following administration of G-CSF, therefore these donros should always be counselled on potential exacerbation of the disease and accepting of potential risk.
Note: individual donor registries may take a more conservative approach due to concerns about the theoretical risk of disease exacerbation. These guidelines serve as an aid for assessing donor suitability, but clinical judgment should always guide decision-making.
References
- Spitzer, T., McAfee, S., Poliquin, C. et al. Acute gouty arthritis following recombinant human granulocyte colony-stimulating factor therapy in an allogeneic blood stem cell donor. Bone Marrow Transplant 21, 966–967 (1998). https://doi.org/10.1038/sj.bmt.1701196
- Allopurinol-Induced Stevens-Johnson Syndrome in Javanese Men With Positive HLA-B*58:01.Ferdiana A, Fachiroh J, Oktarina DAM, Irwanto A, Mahendra C, Febriana SA, Soebono H.Front Genet. 2022 Jun 13;13:839154. doi: 10.3389/fgene.2022.839154. eCollection 2022.PMID: 35769987