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1
A.Wahyu, Larasati, and Pramarta Y. Dwiputra. "Differences The Incidence of Hyperuricemia in Families with Gouty Arthritis and Families Without Gouty Arthritis in Buleleng Regional General Hospital, Bali, Indonesian." Jurnal Indonesia Sosial Teknologi 5, no. 4 (April 19, 2024): 1408–14. http://dx.doi.org/10.59141/jist.v5i4.1010.
Full textAbstract:
The most common manifestation of hyperuricemia is gout. Hyperuricemia is the leading cause of gout. It is about five times more common than gout. The heritability of hyperuricemia and gout is about 73%, and 40-50% of patients have a family history of gout. Indonesia, especially Bali, has a high prevalence of hyperuricemia in families with gout at 26.6%. Therefore, we performed this study to look for differences in the incidence of hyperuricemia in families with gouty arthritis and families without gouty arthritis. In an unpaired case-control study, which is the target population is Balinese, the target population is Balinese individuals with gouty arthritis who come to the Internal Medicine Polyclinic of Buleleng Regional General Hospital. The controls in this study were Balinese individuals without gouty arthritis; there were 41 samples who made a pedigree and checked serum uric acid at one time. Of the total 41 case-control samples used, the incidence of hyperuricemia in families with gouty arthritis is 65.9%, and in families without gouty arthritis, is 29.3%, with an Odd Ratio (OR) value of 2.25 with a 95% confidence interval, p-value = 0.002. There were differences in hyperuricemia incidence in families with gouty arthritis and families without gouty arthritis with a p-value = 0.002. Hyperuricemia in families with gouty arthritis is 2.25 times (OR) higher than in families without gouty arthritis.
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Scipioni, Rosa, Luciano Frate, Valentino Di Tomasso, Michele Saltarelli, Francesco Carubbi, and Marco Petrarca. "Images in clinical medicine: gouty arthritis with osteomyelitis." Italian Journal of Medicine 12, no. 4 (September 13, 2018): 270–72. http://dx.doi.org/10.4081/itjm.2018.1047.
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Gout is one of the most common inflammatory arthropathies, characterized by the deposition of monosodium urate crystals in the synovial membrane, articular cartilage and periarticular tissues and leading to inflammation. The natural history of articular gout is typically composed of four periods: asymptomatic hyperuricemia, episodes of acute attacks of gout (acute gouty arthritis) with asymptomatic intervals (intercritical gout), and chronic tophaceous gout. Tophi develop in 12-35% of gouty patients without adequate control of uricemia. Initially, they do not cause significant complaints or function limitation of the nearby joints. However, if they become larger, joint instability and movement range limitation, joint function impairment and bone erosions and infection at the sites of their penetration can develop.We report a case of a poorly controlled polyarticular tophaceous gout complicated by osteomyelitis.
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Rossiyah, Nella. "RISK FACTOR FOR GOUT AND PREVENTION : A SYSTEMATIC REVIEW." Journal of Advance Research in Medical & Health Science (ISSN: 2208-2425) 9, no. 3 (March 24, 2023): 68–73. http://dx.doi.org/10.53555/nnmhs.v9i3.1615.
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Due to the supersaturation of uric acid, monosodium urate monohydrate crystals accumulate in the tissues, causing gout. Gout is characterized by elevated serum urate levels, acute gouty arthritic episodes, the production of tophi, gouty nephropathy, and uric acid stones. Until now there is no definite percentage/number of people with gout arthritis in the world, due to differences in research sampling methods in determining the number of sufferers of this disease. However, especially in America, there has been a significant increase in cases of gouty arthritis in the last 10 years. Uric acid is a waste product created by the body when renewing cells of gout patients produce more uric acid in the body and the body is unable to eliminate uric acid through urine, causing uric acid to accumulate in the blood. Significant roles are played by genetics, gender, and diet (alcohol intake, obesity) in the development of gout. The underlying cause of hyperuricemia determines the elements that lead to the development of gout. A diet heavy in purines can precipitate gout episodes in individuals with congenital defects in purine metabolism that result in elevated uric acid generation. Many risk factors for gout have been identified via research, including alcohol risk behavior (only in males), body mass index, estimated glomerular filtration rate, triglycerides, and triglyceride levels. Gout sufferers should avoid uric acid-raising meals and beverages. The patient drinks plenty of water. Gout sufferers should exercise regularly. To maintain weight, walk 150 minutes per week or 30 minutes each day. Avoid uric acid-raising medications like hydrochlorothiazide, aspirin, and cyclosporine.
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Putri, Sari Ananda, Naziyah Naziyah, and Cholisa Suralaga. "Efektivitas Kompres Hangat pada Lansia terhadap Penurunan Nyeri Gout Arthritis di Posbindu Kemuning Baktijaya Depok." Malahayati Nursing Journal 5, no. 7 (June 26, 2023): 2267–79. http://dx.doi.org/10.33024/mnj.v5i7.9047.
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ABSTRACT A metabolic condition known as gouty arthritis or gout is characterized by acute joint inflammation caused by the formation of crystallized uric acid. Uric acid levels are elevated in some people who consume purine-rice foods. There are many different factors that contribute to gouty arthritis, such as eating habits that increase uric acid levels and a diet high in purines. Losing weight, drinking plenty of water, avoiding foods that can cause gouty arthritis are ways to prevent it. To examine the effect of warm compress on decreasing pain in elderly with arthritis gout at Posbindu Kemuning Baktijaya Depok. This study used a pre and post test quasy-experiment design. The sample amounted to 32 patients with gouty arthritis. The sampling technique used purposive sampling technique. The research instrument consists of a Numeric Rating Scale and warm compresses. The data were analyzed using the Wilxocon test to determine the effectiveness of warm compresses on the elderly on reducing gouty arthritis pain in Posbindu Kemuning Baktijaya, Depok City. The results of the Asymp Sign value =0.000 or (p value 0.005) show that Ha is accepted and Ho is rejected, this study shows that warm compresses are effective in reducing pain in elderly people wth gouty arthritis at Posbindu Kemuning Baktijaya Depok. Patients with gouty arthritis can effectively manage their pain by applying warm compresses. It is hoped that warm compresses can be applied independently by elderly people with gouty arhritis. Keywords: Gout Arthritis, Warm Compress, Pain ABSTRAK Suatu kondisi metabolik yang dikenal sebagai artritis gout atau asam urat ditandai dengan inflamasi sendi akut yang disebabkan oleh pembentukan asam urat yang mengkristal. Kadar asam urat meningkat pada beberapa orang yang mengonsumsi makanan kaya purin. Ada banyak faktor berbeda yang berkontribusi terhadap artritis gout, seperti kebiasaan makan yang meningkatkan kadar asam urat dan diet tinggi purin. Menurunkan berat badan, minum banyak air putih, menghindari makanan yang dapat menyebabkan gout arthritis adalah cara-cara pencegahannya. Tujuan dari penelitian ini adalah untuk melihat apakah kompres hangat efektif dalam menurunkan nyeri gout arthritis pada lansia di Posbindu Kemuning Baktijaya Kota Depok. Penelitian ini menggunakan desain quasy-experiment pra dan pasca test. Sampel berjumlah 32 pasien gout arthritis. Teknik pengambilan sampel menggunakan purposive sampling technique. Instrument penelitian terdiri dari Numeric Rating Scale dan kompres hangat. Data dianalisis menggunakan uji wilxocon untuk mengetahui efektivitas kompres hangat pada lansia terhadap penurunan nyeri gout arthritis di Posbindu Kemuning Baktijaya Kota Depok.Dengan hasil nilai Asymp Sign = 0,000 atau (p value 0,005) menunjukan Ha diterima dan Ho ditolak, penelitian ini menunjukan kompres hangat efektif menurunkan nyeri pada lansia penderita artritis gout di Posbindu Kemuning Baktijaya Depok. Penderita gout arthritis secara efektif dapat mengatasi rasa sakitnya dengan melakukan kompres hangat. Kata Kunci: Gout Arthritis, Kompres Hangat, Nyeri
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Gregoline, PE, ML Peshoff, and MJ Trepal. "Gout and hypothyroidism." Journal of the American Podiatric Medical Association 87, no. 8 (August 1, 1997): 394–96. http://dx.doi.org/10.7547/87507315-87-8-394.
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A case of gout in a patient with primary hypothyroidism has been presented. Often missed as a companion of gout, hypothyroidism has a frequency of occurrence with gout that is significant and is probably a precipitating factor in these gouty attacks. The physician should be alert for signs and symptoms of this often occult disease in patients with hyperuricemia and gout.
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Anis Rahmawati. "Potensi Kompres Hangat Jahe Merah Sebagai Terapi komplementer Terhadap Pengurangan Nyeri Artritis Gout." Jurnal Ilmiah Pamenang 3, no. 1 (June 30, 2021): 7–15. http://dx.doi.org/10.53599/jip.v3i1.76.
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AbstrakArtritis gout merupakan salah satu penyakit Metabolisme yang disebabkan oleh penumpukan monosodium urate monohydrate crystals pada sendi. Gejala utama yang lazim dirasakan oleh penderita gout artritis adalah nyeri sendi. Untuk mengatasi nyeri terapi farmakologi yang lazim diberikan adalah obat obatan analgesik. Penggunaan antinyeri pada penderita gout artritis yang umumnya dibutuhkan dalam jangka waktu yang panjang dan banyak yang timbulnya efek samping sehingga terapi non farmakologis diharapkan menjadi alternatif untuk mengurangi nyeri artritis gout sehingga menurunkan penggunaan obat antinyeri. Salah satu terapi komplementer untuk mengurangi nyeri gout artritis adalah terapi kompres jahe. Tujuan tinjauan pustaka ini adalah untuk mengkaji lebih dalam publikasi hasil penelitian yang berkaitan dengan terapi kompres jahe untuk mengatasi nyeri pada penderita gout artritis. Metode penulisan studi literatur ini adalah merujuk artikel publikasi pada jurnal nasional maupun internasional dengan topik terkait, meringkas, membandingkan hasil dan disajikan dalam bentuk artikel. Hasil dari penelusuran artikel publikasi yang terkait secara keseluruhan menyatakan bahwa kompres jahe hangat dapat mengurangi nyeri pada artritis gout. Kesimpulan yang dapat diambil adalah kompres jahe hangat adalah pengobatan tradisional atau terapi alternatif untuk mengurangi nyeri sendi gout.
Kata kunci : gout artritis, kompres jahe
Abstract
Gouty arthritis is a metabolic disease caused by a buildup of monosodium urate monohydrate crystals in the joints. The main symptom commonly felt by people with arthritis gout is joint pain. To deal with pain, pharmacological therapy that is commonly given is analgesic drugs. The use of painkillers in people with gouty arthritis is generally needed for a long period of time and there are many side effects so that non-pharmacological therapy is expected to be an alternative to reduce gouty arthritis pain so as to reduce the use of painkillers. One of the complementary therapies to reduce gouty arthritis pain is ginger compress therapy. The purpose of this literature review is to examine the publication of research results related to ginger compress therapy for pain management in patients with gout arthritis. The method of writing this literature study is to refer to published articles in national and international journals with related topics, summarize, compare results and present them in the form of articles. The results of the search for related published articles as a whole suggest that warm ginger compresses can reduce pain in gouty arthritis. The conclusion that can be drawn is warm ginger compress is a traditional medicine or alternative therapy to reduce gout joint pain.
Keywords: Gouty Arthritis Pain, Warm Compress, Red Ging
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Zhang, Yingling, Simin Chen, Man Yuan, Yu Xu, and Hongxi Xu. "Gout and Diet: A Comprehensive Review of Mechanisms and Management." Nutrients 14, no. 17 (August 26, 2022): 3525. http://dx.doi.org/10.3390/nu14173525.
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Gout is well known as an inflammatory rheumatic disease presenting with arthritis and abnormal metabolism of uric acid. The recognition of diet-induced systemic metabolic pathways have provided new mechanistic insights and potential interventions on gout progression. However, the dietary recommendations for gouty patients generally focus on food categories, with few simultaneous considerations of nutritional factors and systemic metabolism. It is worthwhile to comprehensively review the mechanistic findings and potential interventions of diet-related nutrients against the development of gout, including purine metabolism, urate deposition, and gouty inflammation. Although piecemeal modifications of various nutrients often provide incomplete dietary recommendations, understanding the role of nutritional factors in gouty development can help patients choose their healthy diet based on personal preference and disease course. The combination of dietary management and medication may potentially achieve enhanced treatment effects, especially for severe patients. Therefore, the role of dietary and nutritional factors in the development of gout is systematically reviewed to propose dietary modification strategies for gout management by: (1) reducing nutritional risk factors against metabolic syndrome; (2) supplementing with beneficial nutrients to affect uric acid metabolism and gouty inflammation; and (3) considering nutritional modification combined with medication supplementation to decrease the frequency of gout flares.
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Aden, Durre, Prajwala Gupta, and Minakshi Bharadwaj. "Fine-needle aspiration cytology of periarticular nodule – Atypical presentation of gouty tophi: A report of two cases." Cytojournal 19 (August 5, 2022): 48. http://dx.doi.org/10.25259/cytojournal_6_2022.
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Gout is a chronic arthropathy caused due to the deposition of monosodium urate crystals. Gouty tophus can be the initial presenting feature of gout with or without any clinical symptoms. Demonstration of urate crystals in synovial fluid or biopsy helps in confirming the diagnosis of gout. However, fine-needle aspiration cytology (FNAC) of periarticular soft-tissue nodules is a valuable tool in the diagnosis of gout. We present two such cases of isolated soft-tissue lesions wherein the initial diagnosis of gouty tophus was made on FNAC and subsequently followed by a clinical and biochemical workup.
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Tabi-Amponsah, Adwoa Dansoa, Sarah Stewart, Graham Hosie, Lisa K. Stamp, William J. Taylor, and Nicola Dalbeth. "Gout Remission as a Goal of Urate-Lowering Therapy: A Critical Review." Pharmaceuticals 16, no. 6 (May 23, 2023): 779. http://dx.doi.org/10.3390/ph16060779.
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Urate-lowering therapies for the management of gout lead to a reduction in serum urate levels, monosodium urate crystal deposition, and the clinical features of gout, including painful and disabling gout flares, chronic gouty arthritis, and tophi. Thus, disease remission is a potential goal of urate-lowering therapy. In 2016, preliminary gout remission criteria were developed by a large group of rheumatologists and researchers with expertise in gout. The preliminary gout remission criteria were defined as: serum urate < 0.36 mmol/L (6 mg/dL); an absence of gout flares; an absence of tophi; pain due to gout < 2 on a 0–10 scale; and a patient global assessment < 2 on a 0–10 scale over a 12-month period. In this critical review, we describe the development of the preliminary gout remission criteria, the properties of the preliminary gout remission criteria, and clinical studies of gout remission in people taking urate-lowering therapy. We also describe a future research agenda for gout remission.
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Liu, Lu, Shuang He, Lin Jia, Hua Yao, Dan Zhou, Xiaobin Guo, and Lei Miao. "Correlation analysis of serum TLR4 protein levels and TLR4 gene polymorphisms in gouty arthritis patients." PLOS ONE 19, no. 4 (April 23, 2024): e0300582. http://dx.doi.org/10.1371/journal.pone.0300582.
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Objective The Toll-like receptor (TLR) 4-mediated nuclear factor kappa B (NF-κB) signaling pathway regulates the production of inflammatory factors and plays a key role in the pathogenesis of gouty arthritis. The aim of the present study was to investigate the link among TLR4 gene polymorphisms at various loci, protein expression, and gouty arthritis susceptibility. Methods Between 2016 and 2021, a case-control study was used to collect a total of 1207 study subjects, including 317 male patients with gouty arthritis (gout group) and 890 healthy males (control group). The association between gout susceptibility and different genetic models was analyzed by typing three loci of the TLR4 gene (rs2149356, rs2737191, and rs10759932) using a multiplex point mutation rapid assay, and the association between protein expression and gout was confirmed by measuring TLR4 protein concentrations using enzyme-linked immunosorbent assays (ELISAs). Results In a codominant models AA and AG, the rs2737191 polymorphism in the gout group increased the risk of gout compared to the AA genotype (OR = 2.249, 95%CI 1.010~5.008), and the risk of gout was higher for those carrying the G allele compared to the A allele (OR = 2.227, 95%CI 1.006~4.932). TLR4 protein expression was different between the two groups with different locus genotypes. The differences in TLR4 protein expression between the gout group and control group were statistically significant between the following genotypes: the GG and GT genotypes of the rs2149356 polymorphism; the AA and AG genotypes of the rs2737191 polymorphism; and the TT and TC genotypes of the rs10759932 polymorphism(P<0.05). The TLR4 protein level in the gout group (19.19±3.09 ng/ml) was significantly higher than that in the control group (15.85±4.75 ng/ml). Conclusion The AG genotype of the TLR4 gene rs2737191 polymorphism may be correlated with the development of gouty arthritis. The level of TLR4 protein expression is significantly higher in patients with gouty arthritis than in controls, and there is a correlation between high TLR4 protein expression and the development of gouty arthritis.
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Tseng, Chia-Chun, Man Chun Wong, Wei-Ting Liao, Chung-Jen Chen, Su-Chen Lee, Jeng-Hsien Yen, and Shun-Jen Chang. "Systemic Investigation of Promoter-wide Methylome and Genome Variations in Gout." International Journal of Molecular Sciences 21, no. 13 (July 1, 2020): 4702. http://dx.doi.org/10.3390/ijms21134702.
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Current knowledge of gout centers on hyperuricemia. Relatively little is known regarding the pathogenesis of gouty inflammation. To investigate the epigenetic background of gouty inflammation independent of hyperuricemia and its relationship to genetics, 69 gout patients and 1455 non-gout controls were included. Promoter-wide methylation was profiled with EPIC array. Whole-genome sequencing data were included for genetic and methylation quantitative trait loci (meQTL) analyses and causal inference tests. Identified loci were subjected to co-methylation analysis and functional localization with DNase hypersensitivity and histone marks analysis. An expression database was queried to clarify biologic functions of identified loci. A transcription factor dataset was integrated to identify transcription factors coordinating respective expression. In total, seven CpG loci involved in interleukin-1β production survived genetic/meQTL analyses, or causal inference tests. None had a significant relationship with various metabolic traits. Additional analysis suggested gouty inflammation, instead of hyperuricemia, provides the link between these CpG sites and gout. Six (PGGT1B, INSIG1, ANGPTL2, JNK1, UBAP1, and RAPTOR) were novel genes in the field of gout. One (CNTN5) was previously associated with gouty inflammation. Transcription factor mapping identified several potential transcription factors implicated in the link between differential methylation, interleukin-1β production, and gouty inflammation. In conclusion, this study revealed several novel genes specific to gouty inflammation and provided enhanced insight into the biological basis of gouty inflammation.
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Afzal, Asma, Shameem Ahmad Rather, and Shabir Ahmad Bhat. "Gouty Arthritis and Its Appraisal in Greco-Arab (Unani) Medicine." International Journal of Research and Review 11, no. 6 (June 26, 2024): 818–27. http://dx.doi.org/10.52403/ijrr.20240688.
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A typical excruciating type of inflammatory arthritis, Gout, often affects big toe joint and sometimes other joints and viscera as well. In Greco-Arab (Unani) medicine gout is known as Niqris. There is ample literature regarding gouty arthritis available in the treatise of Greco-Arab medicine, an age old existing medicinal system. The aim of this study is to explore the medicinal treasure for gout in Greco-Arab medicine, correlate it with the modern science to amplify the knowledge and widen the field of research avenues. More efficient, cost-effective management of gouty arthritis with least side effects could be achieved with these medicines. Keywords: Arthritis, Gout, Niqris, Unani
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Horváthová, Veronika, Jana Bohatá, Markéta Pavlíková, Kateřina Pavelcová, Karel Pavelka, Ladislav Šenolt, and Blanka Stibůrková. "Interaction of the p.Q141K Variant of the ABCG2 Gene with Clinical Data and Cytokine Levels in Primary Hyperuricemia and Gout." Journal of Clinical Medicine 8, no. 11 (November 14, 2019): 1965. http://dx.doi.org/10.3390/jcm8111965.
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Gout is an inflammatory arthritis influenced by environmental risk factors and genetic variants. The common dysfunctional p.Q141K allele of the ABCG2 gene affects gout development. We sought after the possible association between the p.Q141K variant and gout risk factors, biochemical, and clinical determinants in hyperuricemic, gouty, and acute gouty arthritis cohorts. Further, we studied the correlation of p.Q141K allele and levels of pro-/anti-inflammatory cytokines. Coding regions of the ABCG2 gene were analyzed in 70 primary hyperuricemic, 182 gout patients, and 132 normouricemic individuals. Their genotypes were compared with demographic and clinical parameters. Plasma levels of 27 cytokines were determined using a human multiplex cytokine assay. The p.Q141K variant was observed in younger hyperuricemic/gout individuals (p = 0.0003), which was associated with earlier disease onset (p = 0.004), trend toward lower BMI (p = 0.056), and C-reactive protein (CRP, p = 0.007) but a higher glomerular filtration rate (GFR, p = 0.035). Levels of 19 cytokines were higher, mainly in patients with acute gouty arthritis (p < 0.001), irrespective of the presence of the p.Q141K variant. The p.Q141K variant influences the age of onset of primary hyperuricemia or gout and other disease-linked risk factors and symptoms. There was no association with cytokine levels in the circulation.
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KONATALAPALLI, RUKMINI M., ELENA LUMEZANU, JAMES S. JELINEK, MARK D. MURPHEY, HONG WANG, and ARTHUR WEINSTEIN. "Correlates of Axial Gout: A Cross-sectional Study." Journal of Rheumatology 39, no. 7 (April 15, 2012): 1445–49. http://dx.doi.org/10.3899/jrheum.111517.
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Objective.A cross-sectional study was undertaken to determine the prevalence of axial gout in patients with established gouty arthritis and to analyze clinical, laboratory, and radiological correlations.Methods.Forty-eight subjects with a history of gouty arthritis (American College of Rheumatology criteria) for ≥ 3 years under poor control were included. Subjects underwent history, physical examination, laboratory testing, and imaging studies, including radiographs of the hands and feet and computerized tomography (CT) of the cervical and lumbar spines and sacroiliac joints (SIJ). Patients with characteristic erosions and/or tophi in the spine or SIJ were considered to have axial or spinal gout.Results.Seventeen patients (35%) had CT evidence of spinal erosions and/or tophi, with tophi identified in 7 of the 48 subjects (15%). The spinal location of axial gout was cervical in 7 patients (15%), lumbar in 16 (94%), SIJ in 1 (6%), and more than 1 location in 14 (82%). Duration of gout, presence of back pain, and serum uric acid levels did not correlate with axial gout. Extremity radiographs characteristic of gouty arthropathy found in 21 patients (45%) were strongly correlated with CT evidence of axial gout (p < 0.001). All patients with tophi in the spine had abnormal hand or feet radiographs (p = 0.005).Conclusion.Axial gout may be a common feature of chronic gouty arthritis. The lack of correlation with back pain, the infrequent use of CT imaging in patients with back pain, and the lack of recognition of the problem of spinal involvement in gouty arthritis suggest that this diagnosis is often missed.
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Shukla, Rahul, Ronald B. Vender, Ayman Alhabeeb, Samih Salama, and Frank Murphy. "Miliarial Gout (A New Entity)." Journal of Cutaneous Medicine and Surgery 11, no. 1 (January 2007): 31–34. http://dx.doi.org/10.2310/7750.2007.00002.
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Background: Tophaceous gout typically presents as a subcutaneous, nodular collection of monosodium urate crystals sharply circumscribed from surrounding tissues. Although intradermal cutaneous manifestations of gout have been described, no reported cases of miliarial gout remain. Objective: We describe the first known presentation of miliarial gout and list other uncommon cutaneous manifestations of gouty tophi. The treatment of miliarial gout is discussed, as well as risk factors predisposing an individual to the development of intradermal tophi. Results: Miliarial gout is an intradermal phenomenon consisting of multiple tiny papules containing material of a white to cream color scattered on an erythematous base that responds to allopurinol administration. Risk factors predisposing an individual to the development of intradermal gout include renal insufficiency, hypertension, chronic diuretic therapy, long duration of disease, and lack of consistent use of urate-lowering therapy. Conclusion: Miliarial gout is a unique intradermal manifestation of tophaceous gout.
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Muna, Naila, and Wiwiek Natalya. "Penerapan Tindakan Kompres Hangat Dalam Menurunkan Skala Nyeri Pada Penderita Gout Arthritis." Prosiding Seminar Nasional Kesehatan 1 (December 22, 2021): 1753–57. http://dx.doi.org/10.48144/prosiding.v1i.928.
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AbstractGouty Arthritis is a disease associated with an inborn errors of purine matabolism. Gout Arthritis occurs due to a buildup of uric acid that exceeds the normal limit in the joints. This can cause pain in gouty arthritis sufferers so giving warm compresses is necessary for gouty arthritis sufferers. This study was a descriptive case study aiming to describe the application of warm compresses in reducing pain scale in patirnts with Gouty Arthritis. A client assessment form, observation sheets, pain scales, WWZ (Warm Water Zak), and uric acid measurement kid were the instuments being used to collect data. The findings showed that there was a decrease in the pain scale in patiens with Gouty Arthritis. In case I, there was a decrease of pain scale from 5 to 2; meanwhile, in case II the pain scale decreased from 6 to 3. The conclusion from this study was that the application of warm compress therapy with WWZ (Warm Water Zak) could reduce the pain scale. Thus, patients of Gouty Arthritis are suggested to apply warm compress therapy with WWZ (Warm Water Zak) to reduce the pain because of the disease.Keywords: Warm compress, pain, gouty arthritis
AbstrakGout Arthritis merupakan hasil metabolisme atau pecahan purin dari makanan yang tinggi purin. Gout Arthritis terjadi karena penumpukan asam urat yang melebihi batas normal dipersendian. Hal ini dapat menyebabkan nyeri pada penderita gout arthritis sehingga pemberian kompres hangat sangat diperlukan untuk penderita gout arthritis. Studi kasus ini bertujuan untuk menggambarkan penerapan tindakan kompres hangat dalam menurunkan skala nyeri pada penderita Gout Arthtitis. Metode studi kasus ini menggunakan studi kasus deskriptif. Instrumen studi kasus ini dengan menggunakan format pengkajian klien, lembar observasi, skala nyeri, WWZ (Warm Water Zak) dan alat ukur untuk mengukur kadar asam urat. Hasil studi kasus ini menunjukkan ada penurunan skala nyeri pada penderita Gout Arthritis pada kasus I terjadi penurunan skala nyeri awal 5 turun menjadi 2 sedangkan pada kasus II skala nyeri awal 6 turun menjadi 3. Simpulan dari studi kasus ini bahwa terapi kompres hangat dengan WWZ (Warm Water Zak) dapat menurunkan skala nyeri. Saran bagi klien yang mengalami Gout Arthritis agar dapat mengontrol dengan menggunakan terapi kompres hangat menggunakan WWZ (Warm Water Zak) secara mandiri.Kata kunci: Kompres hangat, nyeri, gout arthritis
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Tomaszuk, Sebastian, Karolina Wąsik, and Magda Wojtuś. "Nutritional factors in the prevention and treatment of gout." Quality in Sport 9, no. 2 (February 18, 2023): 29–36. http://dx.doi.org/10.12775/qs.2023.09.02.004.
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Introduction and purpose: Despite the fact that effective urate lowering therapy and anti-inflammatory drugs for the treatment of gout are commonly available, there is considerable interest in novel treatment approaches. Gouty patients often have a multitude of comorbidities, which lead to concern over drug–drug interactions and medication adverse events. Thus, diet modifications are examined as a way of nonpharmacological treatment of gout. In this review, we explore the potential impact of nutritional factors on hyperuricemia and clinical gout outcomes. A search was conducted using PubMed and Google Scholarship databases.
Brief description of the state of knowledge: Management in patients with gout should be holistic. Incorrect nutrition may lead to hyperuricemia. Studies to date suggest that avoidance of certain foods and beverages can decrease the frequency of gout flares. Weight loss may be beneficial for prevention as well as treatment of gout and its comorbidities. The impact of various types of diet on the course of gout has been given particular attention and recent research suggests that vegetarian, mediterranean and dash diets may be beneficial for gouty patients. Also, some vitamins and omega-3 PUFA have favorable effects and the potential clinical use in gout treatment.
Conclusions: We propose that simple dietary regimens may be beneficial to complement therapeutic management or contribute to the prevention of flares in gout patients. Although piecemeal modifications of various nutrients often provide incomplete dietary recommendations, understanding the role of nutritional factors in gout development would be helpful for patients in choosing their healthy diet.
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Wu, Chien-Hsing, Chih-Chao Yang, Hsueh-Wen Chang, Bin Huang, Chung-Jen Chen, Eton I.-Cheng Lin, Chien-Yi Wu, et al. "Urinary Uromodulin/Creatinine Ratio as a Potential Clinical Biomarker for Chronic Kidney Disease Patients with Gout: A Pilot Study." Medical Principles and Practice 28, no. 3 (2019): 273–79. http://dx.doi.org/10.1159/000496844.
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Objective: Recent studies have reported that reduced excretion of urinary uromodulin is associated with renal tubular function and risks of progressive kidney disease. Gouty nephropathy is usually seen in patients with gout. Patients with chronic gouty nephropathy are characterized by the deposition of monosodium urate crystals primarily involving the collecting ducts in the medulla. We postulated that this correlation may be specific to gout and may serve as a useful biomarker for chronic kidney disease (CKD). Materials and Methods: A total of 114 Taiwanese patients diagnosed with gout (n = 72), CKD (n = 26), or healthy volunteers (n = 16) were prospectively enrolled for this study from the Rheumatology and Nephrology Outpatient Clinics of our institution. We obtained urine and blood samples on patient visits to the outpatient clinics. Demographic data were obtained from medical records. Results: In patients with gout, the spot urinary uromodulin/creatinine ratio (uUMCR; mg/g) in patients with CKD was significantly lower than that in those without CKD (CKD group: 2.2; non-CKD group: 5.6, p = 0.005). Multivariate analysis revealed that patients with CKD and gout had a lower uUMCR than those with gout alone (p = 0.028). A significant association was not observed in our non-gout cohort. Conclusion: The association of decreased uUMCR with CKD status was identified only in patients with gout in the present study. We believe that uUMCR might serve as an indicator of differential CKD in patients with gout.
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Singh, Yogendra, Pankaj Mishra, and Pushpendra Kannojia. "Analysis of animal models based on pre-clinical symptoms of gout." Journal of Drug Delivery and Therapeutics 12, no. 1 (January 15, 2022): 181–84. http://dx.doi.org/10.22270/jddt.v12i1.5270.
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Gout is a type of arthritis, which is a group of related disorders caused by episodes of abnormal inflammation in the joints. It is a metabolic disease characterized by high levels of uric acid in the blood. Uric acid is the end product of purine metabolism and hyperuricemia is caused by abnormalities of purine metabolism. Hyperuricemia is a risk factor for gout, heart disease, high blood pressure (hypertension), diabetes, and acute and chronic kidney disease. This research may attract widespread interest to researchers focusing on the different types of crystalline arthritis. There are over 100 types of arthritis. The most common forms are osteoarthritis (degenerative joint disease), rheumatoid arthritis, gout and pseudo-gout, septic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, still's disease etc.
Many animal models are available to get rid of gout, mainly the hyperuricemia animal model, monosodium urate air pouch gout model, Intra-articular gout in rat, Paw edema, Gouty Arthritis Model, and Gouty nephropathy model. Various investigations have created a reliable and economical animal model for arthritis in a relatively short brief timeframe, manifested by long-term gross and behavioral abnormalities along with intra-articular monosodium urate deposition and tophi formation.
Lately years, hyperuricemia disease has gradually increased in the world. There are many updates that can be made by taking the arthritis model. If such a situation prevails, then in a few years, the patients of gout can increase in great quantity and there is some treatment for this disease. In any case, further review is really needed to focus on its particular pathogenesis and drugs.
Keywords: Gout, Arthritis, Gout Animal Model, Inflammation, Hyperuricemia, monosodium urate, crystalline arthritis.
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Bai, Xueshan, Mingshu Sun, Yuwei He, Ruhua Liu, Lingling Cui, Can Wang, Fang Wan, et al. "Serum CA72-4 is specifically elevated in gout patients and predicts flares." Rheumatology 59, no. 10 (February 22, 2020): 2872–80. http://dx.doi.org/10.1093/rheumatology/keaa046.
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Abstract Objectives Serum CA72-4 levels are elevated in some gout patients but this has not been comprehensively described. The present study profiled serum CA72-4 expression in gout patients and verified the hypothesis that CA72-4 is a predictor of future flares in a prospective gout cohort. Methods To profile CA72-4 expression, a cross-sectional study was conducted in subjects with gouty arthritis, asymptomatic hyperuricaemia, four major arthritis types (OA, RA, SpA, septic arthritis) and healthy controls. A prospective gout cohort study was initiated to test the value of CA72-4 for predicting gout flares. During a 6-month follow-up, gout flares, CA72-4 levels and other gout-related clinical variables were observed at 1, 3 and 6 months. Results CA72-4 was highly expressed in patients with gouty arthritis [median (interquartile range) 4.55 (1.56, 32.64) U/ml] compared with hyperuricaemia patients [1.47 (0.87, 3.29) U/ml], healthy subjects [1.59 (0.99, 3.39) U/ml] and other arthritis patients [septic arthritis, 1.38 (0.99, 2.66) U/ml; RA, 1.58 (0.95, 3.37) U/ml; SpA, 1.56 (0.98, 2.85) U/ml; OA, 1.54 (0.94, 3.34) U/ml; P < 0.001, respectively]. Gout patients with frequent flares (twice or more in the last year) had higher CA72-4 levels than patients with fewer flares (fewer than twice in the last year). High CA72-4 level (>6.9 U/ml) was the strongest predictor of gout flares (hazard ratio = 3.889). Prophylactic colchicine was effective, especially for patients with high CA72-4 levels (P = 0.014). Conclusion CA72-4 levels were upregulated in gout patients who experienced frequent flares and CA72-4 was a useful biomarker to predict future flares.
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Lynn, Jeremy V., Amy L. Strong, and Kevin C. Chung. "Flexor Tendon Rupture Secondary to Gout." Archives of Plastic Surgery 50, no. 05 (September 2023): 492–95. http://dx.doi.org/10.1055/s-0043-1772756.
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AbstractExtra-articular deposition of monosodium urate crystals is a widely recognized manifestation of gout. However, gouty infiltration of flexor tendons in the hand resulting in tendon rupture is exceedingly rare. This case report highlights a patient with gouty infiltration of flexor tendons in the right middle finger resulting in rupture of both the flexor digitorum profundus and flexor digitorum superficialis. Given the extent of gouty infiltration and need for pulley reconstruction, the patient was treated with two-stage flexor tendon reconstruction. Febuxostat was prescribed preoperatively to limit further deposition of monosodium urate crystals and continued postoperatively to maximize the potential for long-lasting results. Prednisone was prescribed between the first- and second-stage operations to prevent a gout flare while the silicone rod was in place. In summary, tendon rupture secondary to gouty infiltration is the most likely diagnosis in patients with a history of gout presenting with tendon insufficiency.
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Bursill, David, William J. Taylor, Robert Terkeltaub, Abhishek Abhishek, Alexander K. So, Ana Beatriz Vargas-Santos, Angelo Lino Gaffo, et al. "Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout." Annals of the Rheumatic Diseases 78, no. 11 (September 9, 2019): 1592–600. http://dx.doi.org/10.1136/annrheumdis-2019-215933.
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ObjectiveThere is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.MethodsA content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.ResultsThe content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: ‘asymptomatic hyperuricaemia’, ‘asymptomatic monosodium urate crystal deposition’, ‘asymptomatic hyperuricaemia with monosodium urate crystal deposition’, ‘gout’, ‘tophaceous gout’, ‘erosive gout’, ‘first gout flare’ and ‘recurrent gout flares’. There was consensus agreement that the label ‘gout’ should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).ConclusionConsensus agreement has been established for the labels and definitions of eight gout disease states, including ‘gout’ itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.
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Radak-Perovic, Marija, and Mirjana Zlatkovic-Svenda. "Novelties in gout." Srpski arhiv za celokupno lekarstvo 141, no. 1-2 (2013): 109–15. http://dx.doi.org/10.2298/sarh1302109r.
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Chronic asymptomatic hyperuratemia (HUA), gout paroxysm in patients with chronic hyperuratemia (HU) and normouricemic attacks of gouty arthritis are well known, but poorly understood. A review of the current literature with attempt of its explanation is presented. The natural course of gout is associated with joint structure changes that may be evaluated by different imaging techniques; comparative advantages and shortcomings of each technique are presented. For almost over 50 years the market has not offered new drugs for the control of HU and gout, while management of such patients was a rather neglected field. Over the last five years an unpredictable number of prospective clinical studies have been conducted involving the investigation of the efficacy and safety of new drugs to control HU (febuxostat, pegloticase). The return of pharmaceutical industry into the world of gout has considerably changed the picture. New recommendations have been presented on appropriate colchicine dose regime for acute gouty flares. Emerging therapies, including pegloticase, uricosuric agent RDEA596 and the interleukin -1 inhibitors have shown promises in early and late phase clinical trials. Each of them deserves to be considered for implementation and feasibility in clinical practice as well as outcome measures for clinical trials. Another purpose of this review was to summarize new knowledge on approved drugs to treat hyperuricemia, or the clinical manifestations of gout. Results of several clinical trials provide new data on the efficacy and safety of the approved urate lowering drugs (allopurinol and febuxostat). Lifestyle and dietary recommendations for gout patients should take into consideration overall health benefits and risks, since gout is often associated with metabolic syndrome and an increased future risk of cardiovascular disease and mortality. This review also summarizes the recent data about lifestyle factors that influence serum uric acid levels and the gout risk, and attempts to provide holistic recommendations, considering both their impact on gout as well as on other health implications.
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Fomin, Viktor V. "Gouty (urate) nephropathy." Consilium Medicum 23, no. 1 (2021): 11–14. http://dx.doi.org/10.26442/20751753.2021.1.200709.
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Clinical variants of kidney damage in gout including asymptomatic disorders of uric acid metabolism are discussed. The risk factor for hyperuricemia and associated kidney damage, clinical variants of gouty nephropathy and approaches to its treatment are presented. Keywords: gout, urate nephropathy, hyperuricemia, uric acid For citation: Fomin VV. Gouty (urate) nephropathy. Consilium Medicum. 2021; 23 (1): 11–14. DOI: 10.26442/20751753.2021.1.200709
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Liu, Lei, Xiaoxia Zhu, Tianyi Zhao, Yiyun Yu, Yu Xue, and Hejian Zou. "Sirt1 ameliorates monosodium urate crystal–induced inflammation by altering macrophage polarization via the PI3K/Akt/STAT6 pathway." Rheumatology 58, no. 9 (May 18, 2019): 1674–83. http://dx.doi.org/10.1093/rheumatology/kez165.
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Abstract Objectives Acute gout is an inflammatory response to MSU crystals. In our previous research, Sirt1 was shown to have an effect in preventing acute gouty inflammation. In the current study, we aimed to investigate the underlying mechanism involving Sirt1 in acute gout. Methods The cytological changes and Sirt1 expression in the synovium were observed in patients with acute or intermittent gout. The effect of Sirt1 and its mechanism in gout were studied in macrophages, C57BL/6 mice and Sirt1+/− mice. Results Sirt1 expression was increased in the peripheral blood mononuclear cells (PBMCs) of patients with acute gout but not in the chronic tophus tissue. The arthritis score and numbers of inflammatory cells in injured paw tissue from murine gout models were upregulated in Sirt1+/− mice compared with wild-type mice. A PCR array of the paw tissue from murine gout models indicated that Sirt1 activation might attenuate MSU-induced inflammation by altering the polarization state of macrophages. Furthermore, in patients with acute gout, the phagocytosis of MSU crystals by a macrophage was found in a smear of the joint fluid and large amounts of macrophages were also found in the synovium. The activation of Sirt1 in gouty mice actually decreased the tendency toward M1 polarization. The inhibition of PI3K/Akt partially blocked the anti-inflammatory effect of Sirt1 and the translocation of STAT6, and phosphorylated STAT6 expression was decreased in RAW 264.7 cells treated with MSU crystals. Conclusion Our studies revealed that Sirt1 ameliorates MSU-induced inflammation by altering macrophage polarization via the PI3K/Akt/STAT6 pathway.
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BOBIRCA, Anca, Cristina ALEXANDRU, Carmen IORGUS, Anca BOANGIU, Anca FLORESCU, Alina DUMITRU, Florin BOBIRCA, Ioan ANCUTA, and Mihai BOJINCA. "Particularities of Patients Dignosed with Gout in Rheumatology Departament." Medicina Moderna - Modern Medicine 29, no. 4 (December 14, 2022): 301–6. http://dx.doi.org/10.31689/rmm.2022.29.4.301.
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Gout is a chronic metabolic disease, characterized by joint inflammation caused by monosodium urate monohydrate crystals. The main objective of this study was to identify the prevalence of gout in a rheumatology department in Romania and secondary to describe the characteristics of patients diagnosed with this condition, with emphasis on the comorbidities. This is a longitudinal, retrospective study on 280 patients from the Department of Internal Medicine and Rheumatology, Dr I Cantacuzino Hospital, from January 2017 to May 2019, diagnosed with chronic or acute gout. The prevalence of gout in our hospital in 2 years period was 0.97%. Gouty attack was diagnosed in 38.2% of cases, while 61.8% were evaluated for chronic gout. Male frequency was 69.6%, alcohol consummation was observed in more than half of the cohort (53.2%) and 72.1% were retired persons. The most frequent comorbidity was hypertension (HBP) (82.1%) followed by dyslipidemia (65.3%), atherosclerotic disease(ATS) (55.0%) and chronic kidney disease (53.9%). There was a significant association between HBP, ATS and dyslipidemia with chronic gout (p=0.038, p=0.022 and p=0.009, respectively). The rate of gouty attack significantly increased with the serum level of uric acid (p<0.001). The therapeutic approach complies with international recommendations.
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Wang, Yangang, Donghua Xu, Bin Wang, and Xu Hou. "Could MicroRNAs be Regulators of Gout Pathogenesis?" Cellular Physiology and Biochemistry 36, no. 6 (2015): 2085–92. http://dx.doi.org/10.1159/000430176.
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MicroRNAs (miRNAs) are a class of noncoding RNAs that mainly negatively regulate gene expression. miRNAs have important roles in many diseases, including inflammatory diseases. Gout is a common arthritis caused by deposition of monosodium urate crystals within joints. Recent studies suggested that miRNAs may be involved in the development of inflammatory arthritis, including acute gouty arthritis. In the present review, we systemically discuss relevant publications in order to provide a better understanding on the possible role of miRNAs in gout. miRNAs may act as regulators of gout pathogenesis via several pathways. Targeting miRNAs may be a promisingstrategy in the treatment of gout.
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Mujaddid, Idulhaq, E. Rosihan, T. H. Handry, and W. Brian. "Tophaceous Gout of Hip Joint Mimicking Bone Tumor." Open Access Macedonian Journal of Medical Sciences 8, no. C (September 14, 2020): 181–83. http://dx.doi.org/10.3889/oamjms.2020.4624.
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BACKGROUND: Gout is a condition characterized by abnormally elevated levels of uric crystals (gouty tophi). It is often to detect in the foot and ankle. Occasionally such tophus is found at rare sites and makes a challenge to the clinician where diagnosis and treatment are concerned.
CASE REPORT: We present a patient who presented to our oncology department with pain on her right hip. It was diagnosed as a benign tumor by the clinical and radiological assessment but intraoperatively turned out to be gouty tophi. Excision surgery has performed, in the 1-year follow-up; there is no relapse of pain.
CONCLUSIONS: Tophaceous gout in the hip joint is a rare case, which clinical and radiology assessments can detect erroneous diagnose. Tophaceous gout in the hip joint mimicked the bone tumor characteristics. It requires a better application and diagnosed for the mimicked tophaceous gout.
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Galozzi, Paola, Sara Bindoli, Andrea Doria, Francesca Oliviero, and Paolo Sfriso. "Autoinflammatory Features in Gouty Arthritis." Journal of Clinical Medicine 10, no. 9 (April 26, 2021): 1880. http://dx.doi.org/10.3390/jcm10091880.
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In the panorama of inflammatory arthritis, gout is the most common and studied disease. It is known that hyperuricemia and monosodium urate (MSU) crystal-induced inflammation provoke crystal deposits in joints. However, since hyperuricemia alone is not sufficient to develop gout, molecular-genetic contributions are necessary to better clinically frame the disease. Herein, we review the autoinflammatory features of gout, from clinical challenges and differential diagnosis, to the autoinflammatory mechanisms, providing also emerging therapeutic options available for targeting the main inflammatory pathways involved in gout pathogenesis. This has important implication as treating the autoinflammatory aspects and not only the dysmetabolic side of gout may provide an effective and safer alternative for patients even in the prevention of possible gouty attacks.
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Bardin, Thomas, Emmanuel Letavernier, and Jean-Michel Correas. "The Gouty Kidney: A Reappraisal." Gout, Urate, and Crystal Deposition Disease 1, no. 1 (March 17, 2023): 25–36. http://dx.doi.org/10.3390/gucdd1010004.
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This review re-examines the role of crystal deposition in the kidney in view of recent clinical and experimental findings. The involvement of the renal system in gout seems frequent. Indeed, recent studies showed that approximately 25% of patients with gout experience renal failure, defined by estimated glomerular filtration rate <60 mL/min/1.73 m2. The pathophysiology is complex and involves several factors, their respective roles being difficult to dissect. The role of crystal deposition in the kidney was the first suspected, and the concept of gouty microcrystalline nephropathy, also called gouty nephropathy, has been popular, supported by early autopsy studies demonstrating uric acid and urate crystal deposition in the renal medulla of patients with gout, together with features of tubulointerstitial nephritis. Crystal deposition was first considered an important source of renal involvement in gout. After the introduction of urate-lowering drugs and the performance of kidney biopsies, which mainly involved the renal cortex and did not reveal much crystal deposition but rather vascular changes, this concept has been criticized and even dismissed. Thereafter, kidney involvement in gout was considered mainly vascular, related to hypertension and associated comorbidities and later to hyperuricemia. The toxic effects of non-steroidal anti-inflammatory drugs is also an important factor. Modern imaging, especially renal ultrasonography, allows for atraumatic exploration of the kidney and has revealed hyperechogenicity of the renal medulla, suggesting crystalline deposits, in approximately one-third of patients with tophaceous gout. Experimental models of gouty nephropathy have recently demonstrated the pathogenic role of microcrystal deposition in the collecting ducts and parenchyma of the renal medulla. Taken together, these recent findings lead to the re-examination of the pathogenic role of crystal deposition in the renal medulla and testing the effect of urate-lowering drugs on renal features of gouty patients with evidence of renal crystal deposition.
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Jiang, Xiaoyan, Anxin Li, Wei Hao, Cheng Yang, Hongyan Wang, and Wuquan Deng. "Limb salvage and systemic management of gouty tophi: Case series." Medicine 103, no. 20 (May 17, 2024): e38137. http://dx.doi.org/10.1097/md.0000000000038137.
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Introduction: Gout is a chronic disease characterized by deposition of monosodium urate crystals. Tophi develop in some individuals with untreated or uncontrolled gout, which leads to ulcerations, cosmetic problems, mechanical obstruction of joint movement, joint damage and musculoskeletal disability. Currently, the treatment of gouty tophi is controversial and challenging. Both surgical and internal medical treatments have limitations and require further exploration in clinical practice. Patient concerns: In Case 1, we treated a patient with severe infection of diabetic foot ulcers with concomitant multiple gouty tophi in the same limb. A systematic management strategy was formulated to close the wound and save the limb. The ulcers healed successfully after half a year. In Case 2, a giant gouty tophi located in the first metatarsophalangeal joint of the left foot was removed by surgical treatment and vancomycin-loaded bone cement implantation. In Case 3, we present a case of gouty tophi that was resolved by standardized systemic medical management. Diagnosis: Three patients were all diagnosed with gout accompanied by gouty deposition, although there were other different comorbidities. Interventions: In case 1, we used debridement to gradually remove gouty tophi. In case 2, the giant gouty tophi was removed by surgical operation. In case 3, the gouty tophi disappeared after standardized treatment with medicine, diet and lifestyle management. Outcomes: Three patients underwent different treatment therapies to remove gouty tophi based on their specific conditions. Lessons: We explored effective interventions for tophi in gout by surgical or other interventions in combination with pharmacotherapy.
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Fairhurst, Rick J., Arnold M. Schwartz, and Leo M. Rozmaryn. "Gouty Tenosynovitis of the Distal Biceps Tendon Insertion Complicated by Partial Rupture." HAND 12, no. 1 (July 8, 2016): NP1—NP5. http://dx.doi.org/10.1177/1558944715627639.
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Background: Given the appreciable prevalence of gout, gout-induced tendon ruptures in the upper extremity are extremely rare. Although these events have been reported only 5 times in the literature, all in patients with a risk factor for or history of gout, they have conspicuously never been diagnosed in the shoulder or elbow. Methods: A 45-year-old, right-hand-dominant man with a history of gout presented with pain in his right anterior elbow and weakness in his forearm after a trivial injury. Results: Here, we report the first case of gouty tenosynovitis of the distal biceps tendon insertion complicated by partial rupture, a composite diagnosis supported by both intraoperative and histological observations. Conclusions: In patients who are clinically diagnosed with biceps tendon rupture and have a history of gout, it is important to consider the possibility of a gout-related pathological manifestation causing or simulating tendon rupture.
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SAKETKOO, LESLEY A., IGNACIO GARCIA-VALLADARES, and LUIS R. ESPINOZA. "Axial Gout: Cinderella of Gouty Arthropathy!" Journal of Rheumatology 39, no. 7 (July 2012): 1314–16. http://dx.doi.org/10.3899/jrheum.120375.
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Wang, Lu, Crystal Rose, Paul Mellen, George Branam, and Maria M. Picken. "Gouty Panniculitis with Ulcerations in a Patient with Multiple Organ Dysfunctions." Case Reports in Rheumatology 2014 (2014): 1–4. http://dx.doi.org/10.1155/2014/320940.
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Gouty panniculitis is a rare manifestation of gout. Clinically, it is characterized by indurated subcutaneous nodules in nonjoint areas. Pathologically, typical characteristic gouty tophi can be seen in subcutaneous tissue. It is postulated that gouty panniculitis develops as a consequence of uric acid accumulation in the body and localized inflammatory changes in subcutaneous tissue. We report a case of a 46-year-old man with 20-year history of gout, who developed multiple subcutaneous nodules over the abdomen and right groin/thigh area over a 2-year period. After a recent episode of congestive heart failure and acute renal failure, the nodules increased in size and the overlying skin became erythematous and ulcerated. Pathologic examination demonstrated typical tophi in the dermis and subcutaneous tissue. A review of the literature yielded fifteen similar cases that had been previously reported. We conclude that gouty panniculitis may be a manifestation of undertreated gout and may be exacerbated by the deterioration of other systemic functions.
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SCHLESINGER, NAOMI, JOSEPHINE M. NORQUIST, and DOUGLAS J. WATSON. "Serum Urate During Acute Gout." Journal of Rheumatology 36, no. 6 (April 15, 2009): 1287–89. http://dx.doi.org/10.3899/jrheum.080938.
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Objective.To study the frequency of normal serum urate (SU) levels during acute gout in the largest studies of acute gout treatment to date.Methods.Data collected from 2 randomized controlled clinical trials assessing the efficacy of etoricoxib or indomethacin for 7 days in acute gout were used to assess SU levels during acute gouty attacks. Efficacy was similar with both agents, so both groups were combined for analysis.Results.A total of 339 patients were enrolled in the 2 studies; 94% were male; mean age was 50.5 years. At baseline, 14% of patients had a “true” normal SU (≤ 6 mg/dl) and 32% had SU ≤ 8 mg/dl during acute gout. Baseline mean SU was 7.1 versus 8.5 mg/dl (p < 0.001) in those taking allopurinol versus nonusers. Patients taking chronic allopurinol were more likely to have lower SU at baseline compared to those not taking chronic allopurinol (p < 0.001) during the acute attack.Conclusion.A normal SU level at presentation does not exclude an acute gouty attack. In the largest studies of acute gout to date, attacks still occurred despite SU levels being below 6.8 mg/dl, the saturation level for urate. This may be attributed to persistence of tophi and an increased body uric acid pool. Additional studies are needed to determine the correlation between SU and the body uric acid pool as well as the relationship to timing of changes during acute gout.
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Polukhina, E. V. "Musculoskeletal ultrasound in gout." Ultrasound & Functional Diagnostics, no. 2 (December 22, 2023): 62–79. http://dx.doi.org/10.24835/1607-0771-2023-2-62-79.
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The article presents a pictorial literature review on musculoskeletal ultrasound in gout, which is the most common cause of inflammatory arthropathy in adults. Nowadays, among imaging modalities, ultrasound provides the best capabilities for gout diagnosing and monitoring by revealing of monosodium urate deposits in various joint structures, assessing the presence and severity of synovial inflammation, including for dynamical evaluation on urate-lowering therapy. The main ultrasound features of gout (double contour sign, tophi, aggregates and erosions) are described according to the current clinical guidelines. Knowing of these features provides the correct interpretation of ultrasound findings for timely diagnosis and differential diagnosis of gouty arthropathy, and dynamical assessment on therapy.
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Flores Martín, José Francisco, Fernando Vázquez Alonso, Ignacio Puche Sanz, Raquel Berrio Campos, Miguel Angel Campaña Gutierrez, and José Manuel Cózar Olmo. "Gouty Tophi in the Penis: A Case Report and Review of the Literature." Case Reports in Urology 2012 (2012): 1–3. http://dx.doi.org/10.1155/2012/594905.
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Gout is a metabolic disease characterized by hyperuricemia and the deposition of monosodium urate crystals in different anatomical locations. We report the case of a 61-year-old man who received consultation for gouty tophi in the penis, which is an unusual location for this type of pathology, that was resolved with the surgical removal of the tophi. We provide a review on gout and its treatment as well as other locations where atypical gouty tophi have been described.
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Lee, Hye Eun, Gabsik Yang, Youn Bum Park, Han Chang Kang, Yong-Yeon Cho, Hye Suk Lee, and Joo Young Lee. "Epigallocatechin-3-Gallate Prevents Acute Gout by Suppressing NLRP3 Inflammasome Activation and Mitochondrial DNA Synthesis." Molecules 24, no. 11 (June 6, 2019): 2138. http://dx.doi.org/10.3390/molecules24112138.
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Gout is a chronic inflammatory disease evoked by the deposition of monosodium urate (MSU) crystals in joint tissues. The nucleotide-binding oligomerization domain (NOD)-like receptor (NLR) family pyrin domain containing 3 (NLRP3) inflammasome is responsible for the gout inflammatory symptoms induced by MSU crystals. We investigated whether epigallocatechin-3-gallate (EGCG) suppresses the activation of the NLRP3 inflammasome, thereby effectively preventing gouty inflammation. EGCG blocked MSU crystal-induced production of caspase-1(p10) and interleukin-1β in primary mouse macrophages, indicating its suppressive effect on the NLRP3 inflammasome. In an acute gout mouse model, oral administration of EGCG to mice effectively alleviated gout inflammatory symptoms in mouse foot tissue injected with MSU crystals. The in vivo suppressive effects of EGCG correlated well with the suppression of the NLRP3 inflammasome in mouse foot tissue. EGCG inhibited the de novo synthesis of mitochondrial DNA as well as the production of reactive oxygen species in primary mouse macrophages, contributing to the suppression of the NLRP3 inflammasome. These results show that EGCG suppresses the activation of the NLRP3 inflammasome in macrophages via the blockade of mitochondrial DNA synthesis, contributing to the prevention of gouty inflammation. The inhibitory effects of EGCG on the NLRP3 inflammasome make EGCG a promising therapeutic option for NLRP3-dependent diseases such as gout.
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Goldberg, Emily Lauren, Jennifer L. Asher, Ryan Molony, Albert Shaw, Caroline Zeiss, Chao Wang, Ludmilla A. Morozova-Roche, Raimund I. Herzog, Akiko Iwasaki, and Vishwa Deep Dixit. "β-hydroxybutyrate deactivates neutrophil NLRP3 inflammasome to relieve gout flares." Journal of Immunology 198, no. 1_Supplement (May 1, 2017): 206.18. http://dx.doi.org/10.4049/jimmunol.198.supp.206.18.
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Abstract Aging and lipotoxicity are two major risk factors for gout that are linked by the activation of the NLRP3 inflammasome. IL-1β produced by macrophages and neutrophils drives gouty flares that cause joint destruction, intense pain and fever. Small clinical trials have reported that IL-1R antagonists reduced pain in gout patients, but these biologicals are expensive and may compromise immune responses. Moreover, current treatment strategies for gout are limited in efficacy and do not specifically target the NLRP3 inflammasome. NLRP3 activation is regulated by numerous metabolic byproducts. However, metabolites that impact neutrophil inflammasome remain unknown. We identified that ketogenic diet (KD) increases beta-hydroxybutyrate (BHB) and alleviates urate crystal-induced gout without impairing immune-defense against bacterial infection. BHB inhibited NLRP3 inflammasome in S100A9 fibril-primed and urate crystal activated macrophages which serve to recruit inflammatory neutrophils in joints. Consistent with reduced gouty flares in outbred rats fed a ketogenic diet, BHB blocked NLRP3-dependent IL-1β secretion from neutrophils from both mice and humans, irrespective of age. Mechanistically, BHB inhibited the NLRP3 inflammasome in neutrophils by reducing priming and assembly steps. Collectively, our studies show that BHB, a known alternate metabolic fuel is also an anti-inflammatory molecule that may serve as a treatment for gout.
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Xi, Shijun, ZhiguoShao, Lu Li, Zhuang Gui, Peng Liu, Qi Jiang, Yuan Yu, et al. "Tongbixiao Pills Improve Gout by Reducing Uric Acid Levels and Inhibiting Inflammation." Dose-Response 20, no. 2 (April 2022): 155932582210903. http://dx.doi.org/10.1177/15593258221090340.
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Gout is a chronic disease. Gout symptoms are often experienced in the middle of the night. The onset of gout in the middle of the night is closely related to abnormal liver and gallbladder meridian. The purpose of this study was to investigate the clinical efficacy and possible mechanism of action of Tongbixiao pills in the treatment of hyperuricemia and gouty arthritis. The Tongbixiao pills we used included several traditional Chinese medicines, most of which tonify the spleen; strengthen the liver; benefit the kidney; and reduce heat, dampness, and blood stasis. In this randomized clinical study of 105 patients, we found that Tongbixiao pills can reduce uric acid levels in hyperuricemia patients. Additionally, the efficacy was similar to that of allopurinol and the level of uric acid did not increase significantly at eight weeks after withdrawal. In the absence of notable adverse reactions, Tongbixiao pills can also increase uric acid excretion, reduce serum creatinine and lipid levels, and reduce inflammation and relieve gout symptoms. In addition, we used SD rats to simulate gout and arthritis and divided them into five groups: normal group, model group, low-dose group, medium-dose group, and high-dose group. The inflammatory indices of the 40 SD rats were observed. After seven days, ankle swelling in rats in the treatment group was significantly reduced. The indices of uric acid, creatinine, and urea nitrogen in the treatment group were significantly lower than those in the model group, which proved that Tongbixiao pills could inhibit hyperuricemia in rats, thus treating gout. This study demonstrates that Tongbixiao pills can treat gout, provide more treatment options for gouty arthritis, and improve the quality of life of patients.
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Stern, L., R. Johnson, P. Shakouri, A. Athavale, B. Lamoreaux, B. Marder, and S. Mandayam. "AB1050 CHARACTERISTICS OF PATIENTS WITH COINCIDENT GOUT AND ADVANCED CHRONIC KIDNEY DISEASE." Annals of the Rheumatic Diseases 81, Suppl 1 (May 23, 2022): 1647.2–1648. http://dx.doi.org/10.1136/annrheumdis-2022-eular.2489.
Full textAbstract:
BackgroundPatients with chronic kidney disease (CKD) are at increased risk for developing gout1 and vice versa.2 Those with both gout and CKD present distinct challenges for patients and physicians because of the high prevalence of other comorbidities and restrictions on gout medication use, including non-steroidal anti-inflammatories3,4 and some oral urate-lowering therapies (ULTs).5 This unique patient population has not been well characterized using real-world data.ObjectivesThis retrospective chart review study of patients with coincident gout and CKD was conducted to better understand patient characteristics and treatment patterns of this population. This study is unique in that patient data were obtained from nephrologists, allowing a glimpse of how they view gout and its management.Methods111 nephrologists provided de-identified medical record data of their most-recently seen advanced (stage 3─5) CKD patients. Patients met study criteria for gout if any of the following were true: gout listed as a comorbidity, ULT use, or visible tophi or gout flares documented. A patient’s gout was determined to be uncontrolled if they had serum uric acid >6 mg/dL in addition to ≥1 visible tophus, ≥2 gout flares in the past year, or gouty arthritis (≥1 tender or swollen joint). Characteristics of this unique population were examined, along with gout management patterns. Differences between patients with controlled and uncontrolled gout were also investigated using data from patients’ most recent evaluation.Results173 patients with stages 3-5 CKD and who met study criteria for gout were included. Mean age was 58.3±18.1 years and BMI averaged 32.0 ± 11.8 kg/m2. A higher than expected proportion of patients were female (47%). The most common comorbidities were hypertension (85%), diabetes mellitus (47%), anemia of CKD (42%), CKD-mineral bone disorder (41%), ischemic heart disease (23%), and congestive heart failure (21%). Mean CKD duration was 4.1 ± 5.5 years, mean estimated glomerular filtration rate (eGFR) at most recent visit was 32.3 ± 13.9 ml/min/1.73 m2, and 62% were using a ULT. 23 patients (13%) had uncontrolled gout (48% female, 63.1 ± 16.4 years, mean eGFR 32.0 ± 14.6 ml/min/1.73 m2), all of whom had been prescribed a ULT. Compared with controlled gout patients, uncontrolled patients had higher rates of pulmonary hypertension (14% vs. 4%), gout-related chronic pain in the 12-months prior to data collection (63% vs. 42%), and joint involvement (joint swelling, tenderness, flexibility loss, and/or damage/lesions on x-ray; 26% vs. 9%). Colchicine was also used more frequently in uncontrolled gout patients (26% vs. 7%).ConclusionThe coincident gout with advanced CKD population described here shows unique differences from the general gout population, including a high proportion of females (47%). Given that women have a lower likelihood of developing gout at the same serum uric acid level,6 this finding was particularly surprising (general gout population: 67% male7). Importantly, nearly 40% of included patients were not utilizing a ULT, leaving them susceptible to developing the painful and debilitating sequalae of uncontrolled gout. Additionally, 41% of the study population had a CKD-related mineral bone disorder, indicating that patients with coincident gout and CKD may have bones that are more vulnerable to gout-related bone damage. Our study confirms a high prevalence of gout and its associated comorbidities in patients with advanced CKD and suggests another nephrology education opportunity to highlight the potential benefits of gout monitoring, earlier intervention, and management.References[1]Safiri S, et al. Arthritis Rheumatol 2020;72:1916-27.[2]Feig DI. Curr Opin Nephrol Hypertens 2009; 18: 526–530.[3]Stamp LK, et al. Nat Rev Rheumatol. 2021; 17(10): 633–641.[4]Wallace SL, et al. J Rheumatol 1991; 18(2): 264-9.[5]Abdelatif AA and Elkhalili N. Am J Ther 2014; 21: 523-34.[6]Bhole V, et al. Arthritis Rheum 2010;62:1069-76.[7]Francis-Sedlak M, et al. Rheumatol Ther 2021;8:183-97.Disclosure of InterestsLeonard Stern Speakers bureau: Horizon Therapeutics, Consultant of: Horizon Therapeutics, Richard Johnson Shareholder of: Colorado Research Partners LLC and XORTX Therapeutics, Speakers bureau: Horizon Therapeutics, Consultant of: Horizon Therapeutics, Payam Shakouri Speakers bureau: Horizon Therapeutics and Relypsa, Consultant of: Horizon Therapeutics, Amod Athavale Grant/research support from: Horizon Therapeutics, Brian LaMoreaux Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Brad Marder Shareholder of: Horizon Therapeutics, Employee of: Horizon Therapeutics, Sreedhar Mandayam Shareholder of: Medingenii Capital LLC and Prosalus Capital LLC, Speakers bureau: Otsuka and Alexion, Consultant of: US Renal Care and Aurinia, Grant/research support from: Travere, Norvartis, Omeros, Roche, Vertex, Equillium, Goldfinch Bio, and Pfizer
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Tajika, Tsuyoshi, Takuro Kuboi, Tokue Mieda, Noboru Oya, Fumitaka Endo, Takuro Nakazawa, and Hirotaka Chikuda. "Digital flexion contracture caused by tophaceous gout in flexor tendon." SAGE Open Medical Case Reports 7 (January 2019): 2050313X1984470. http://dx.doi.org/10.1177/2050313x19844708.
Full textAbstract:
Gouty tophus is an unusual cause of digital flexion contracture. Awareness of this pathophysiology will lead to more confidence in proper treatment and surgical management of this rare condition. This report describes a case of digital flexion contracture by tophaceous gout distinguished between trigger finger and locking of the metacarpophalangeal joint. We found the flexor tendon with a deposited chalky white substance suggestive of gouty tophus intraoperatively. We performed tenosynovectomy and removed the chalky white substance to the greatest degree possible. Histological findings confirmed the diagnosis of gout. Postoperatively, the patient recovered nearly to a full range of motion of the affected digits. When meeting with the patient who has had hyperuricemia and who is unable to extend the affected digits suddenly, one must keep in mind digital flexion contracture caused by tophaceous gout.
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Akhter, Asad S., Ahmed Mohyeldin, and Andrew J. Grossbach. "Acute presentation of spinal gouty arthritis: A case report and review of literature." Surgical Neurology International 10 (November 29, 2019): 232. http://dx.doi.org/10.25259/sni_528_2019.
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Background: Gout is an inflammatory arthritis that results from faulty purine metabolism, affecting approximately 4% of adults in the US, and predominately affects people in the fourth decade of life. Further, spinal gout is rarely the first presentation of gout, especially in younger individuals. Case Description: A 26-year-old male came to the emergency room with acute lower extremity numbness and weakness. The MR demonstrated an enhancing epidural lesion at T6–T8 in the mid-thoracic spine. He subsequently underwent a decompressive laminectomy and fusion at levels T6–T9, resulting in full recovery 1 year later. The pathology demonstrated needle-like monosodium urate crystals consistent with the diagnosis of spinal gouty arthritis. Conclusion: Gout rarely initially presents in a young adult in the spine. Here, we reviewed the case of spinal gout in a 26-year-old male who successfully underwent spinal surgery.
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Saliba, Joe, Hitomi Sakano, Rick A. Friedman, and Jeffrey P. Harris. "Tophaceous Gout of the Middle Ear: Case Reports and Review of the Literature." Audiology and Neurotology 24, no. 2 (2019): 51–55. http://dx.doi.org/10.1159/000500514.
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Tophaceous gout of the middle ear is a rare occurrence that presents as a granular white-colored mass. It is frequently misdiagnosed as cholesteatoma or tympanosclerosis in patients who otherwise may not manifest any clinical or biochemical signs of gout. While uncommon, it can lead to clinically significant disease such as conductive hearing loss. The present report describes 2 cases of middle ear gouty tophi initially mistaken for another entity. Both patients underwent surgery, and the diagnosis of gout was revealed after final histopathological analysis. A review of the literature is also presented.
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Weaver, Jennifer S., Ernest R. Vina, Peter L. Munk, Andrea S. Klauser, Jamie M. Elifritz, and Mihra S. Taljanovic. "Gouty Arthropathy: Review of Clinical Manifestations and Treatment, with Emphasis on Imaging." Journal of Clinical Medicine 11, no. 1 (December 29, 2021): 166. http://dx.doi.org/10.3390/jcm11010166.
Full textAbstract:
Gout, a crystalline arthropathy caused by the deposition of monosodium urate crystals in the articular and periarticular soft tissues, is a frequent cause of painful arthropathy. Imaging has an important role in the initial evaluation as well as the treatment and follow up of gouty arthropathy. The imaging findings of gouty arthropathy on radiography, ultrasonography, computed tomography, dual energy computed tomography, and magnetic resonance imaging are described to include findings of the early, acute and chronic phases of gout. These findings include early monosodium urate deposits, osseous erosions, and tophi, which may involve periarticular tissues, tendons, and bursae. Treatment of gout includes non-steroidal anti-inflammatories, colchicine, glucocorticoids, interleukin-1 inhibitors, xanthine oxidase inhibitors, uricosuric drugs, and recombinant uricase. Imaging is critical in monitoring response to therapy; clinical management can be modulated based on imaging findings. This review article describes the current standard of care in imaging and treatment of gouty arthropathy.
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Cao, Ling, Tianyi Zhao, Chunmei Xie, Shucong Zheng, Weiguo Wan, Hejian Zou, and Xiaoxia Zhu. "Performance of Ultrasound in the Clinical Evaluation of Gout and Hyperuricemia." Journal of Immunology Research 2021 (April 5, 2021): 1–7. http://dx.doi.org/10.1155/2021/5550626.
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Objective. To evaluate monosodium urate (MSU) crystal deposition and related lesions in the joints of patients with gout and hyperuricemia (HUA) using ultrasound. To explore the association between ultrasound findings and clinical features in gout and HUA. Methods. A total of 202 patients with gout and 43 asymptomatic patients with HUA were included. The clinical data and ultrasonic assessment results were collected and statistically analyzed. Results. Deposition of MSU crystals was found in 25.58% (11/43) of patients with asymptomatic HUA and 76.24% (154/202) of patients with gout. Of the 1,082 joints from patients with gout examined, 33.09% (358/1082) displayed MSU crystal deposition. In the joints with MSU crystal deposition, 77.37% (277/358) had a history of attacks. Among the joints of gouty arthritis, double contour sign (DCS), hyperechoic aggregate (HAG), and tophi were found in 32.65% (159/487), 7.80% (38/487), and 24.64% (120/487) of the joints, respectively. DCS and tophi, but not HAG, increasingly appeared with the extension of gout duration. In patients with more than 15 years of gout history, DCS, Tophi, and HAG were found in 48.18%, 40.00%, and 6.36% of US assessed joints, respectively. In patients with gout, synovial lesion and bone erosion were found in 17.74% (192/1082) and 7.58% (82/1082) of joints, respectively. The synovial lesion was related to HAG, while bone erosion was related to tophi and DCS. Nephrolithiasis was detected in 20.30% (41/202) of patients with gout and 4.65% (2/43) of HUA patients, indicating that nephrolithiasis occurred in more patients with gout than in patients with HUA. Conclusion. HAG is an early performance of MSU crystal deposition in joints of gout and HUA. Both DCS and tophi are risk factors for bone erosion. Early urate-lowering therapy (ULT) should be considered in patients with gout, DCS, or tophi.
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Thompson, Joshua W., Sriram Srinivasan, and Damodar Makkuni. "Chronic tophaceous gout mimicking widespread metastasis." BMJ Case Reports 14, no. 5 (May 2021): e236166. http://dx.doi.org/10.1136/bcr-2020-236166.
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Gout is a common crystal-induced arthropathy affecting mainly the joints of the appendicular skeleton; however, rarely this condition affects the axial skeleton as well. Spinal gout can cause radiculopathy, cord compression, canal stenosis and discitis. We describe a case of a 71-year-old woman where the initial presentation of destructive arthropathy and spinal masses secondary to axial gout was mistaken for a metastatic malignancy. Despite chronic polyarthropathy and bilateral subcutaneous gouty tophi, spinal gout was not considered a differential diagnosis during initial assessment.The patient was managed conservatively with pharmacological treatment resulting in improvement of her upper limb radiculopathy and systemic joint pain, although little improvement in mobility. Such extensive involvement is rare and the masses can mimic an underlying metastatic disease. Careful history and clinical examination recognising polyarthropathy and subcutaneous tophi can aid the clinician to make the right diagnosis and institute correct treatment. Delay in recognising gout as a differential diagnosis can lead to marked morbidity as illustrated in our case.
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Razzak, Md Abdur, Quazi Audry Arafat Rahman, and Fahtiha Nasreen. "Hyperuricemia and Gout – Ins and Out." Journal of Armed Forces Medical College, Bangladesh 15, no. 2 (December 20, 2020): 227–34. http://dx.doi.org/10.3329/jafmc.v15i2.50845.
Full textAbstract:
Gout is a condition characterized by the deposition of monosodium urate crystals in the joints or soft tissue. The four phases of gout include asymptomatic hyperuricemia, acute gouty arthritis, intercritical gout and chronic tophaceous gout. The peak incidence occurs in patients 30 to 50 years old, and the condition is much more common in men than in women. Patients with asymptomatic hyperuricemia do not require treatment, but efforts should be made to lower their urate levels by encouraging them to make changes in diet or lifestyle. Acute gout most commonly affects the first metatarsal joint of the foot, but other joints are also commonly involved. Definitive diagnosis requires joint aspiration with demonstration of birefringent crystals in the synovial fluid under a polarized light microscope. Treatment includes nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, corticosteroids and analgesics. In patients without complications, NSAID therapy is preferred.
JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 227-234
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Wang, Xiaoke, Yue Zhang, Meiling Zhang, Hui Kong, Suna Wang, Jinjun Cheng, Huihua Qu, and Yan Zhao. "Novel Carbon Dots Derived from Puerariae lobatae Radix and Their Anti-Gout Effects." Molecules 24, no. 22 (November 16, 2019): 4152. http://dx.doi.org/10.3390/molecules24224152.
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Gout is a disease with a high incidence and causing great harm, and the current treatment drugs are not satisfactory. In this study, novel water-soluble carbon dots (CDs) with anti-gout effect, named Puerariae lobatae Radix CDs (PLR-CDs), are reported. PLR-CDs were synthesized with an improved pyrolysis method at 300 °C, and their characterization was performed with multifaceted approaches, such as transmission electron microscopy (TEM) and ultraviolet–visible (UV–vis) and Fourier-transform infrared (FTIR) spectroscopy. In addition, the biocompatibility of PLR-CDs was studied using the cell counting kit (CCK)-8 in LO2 cells and RAW264.7 cells, and the anti-gout activity of PLR-CDs was examined on animal models of hyperuricemia and gouty arthritis. The characterization of PLR-CDs indicated that they were nearly spherical, with diameters ranging from 3.0 to 10.0 nm, and the lattice spacing was 0.283 nm. The toxicity experiment revealed that PLR-CDs were non-poisonous for LO2 cells and RAW264.7 cells at concentrations below 250 μg/mL. The results of pharmacodynamic experiments showed that PLR-CDs could lower the blood uric acid level in model rats by inhibiting the activity of xanthine oxidase and reduce the degree of swelling and pathological damage of gouty arthritis. Thus, PLR-CDs with anti-gout biological activity and good biocompatibility have the prospect of clinical application for the treatment of gout.
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Chen, Kuan-Jung, Yen-Chun Huang, Yu-Cheng Yao, Wei Hsiung, Po-Hsin Chou, Shih-Tien Wang, Ming-Chau Chang, and Hsi-Hsien Lin. "Risk Factors for Postsurgical Gout Flares after Thoracolumbar Spine Surgeries." Journal of Clinical Medicine 11, no. 13 (June 28, 2022): 3749. http://dx.doi.org/10.3390/jcm11133749.
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Gouty arthritis is the most common form of inflammatory arthritis and flares frequently after surgeries. Such flares impede early patient mobilization and lengthen hospital stays; however, little has been reported on gout flares after spinal procedures. This study reviewed a database of 6439 adult patients who underwent thoracolumbar spine surgery between January 2009 and June 2021, and 128 patients who had a history of gouty arthritis were included. Baseline characteristics and operative details were compared between the flare-up and no-flare groups. Multivariate logistic regression was used to analyze predictors and construct a predictive model of postoperative flares. This model was validated using a receiver operating characteristic (ROC) curve analysis. Fifty-six patients (43.8%) had postsurgical gout flares. Multivariate analysis identified gout medication use (odds ratio [OR], 0.32; 95% confidence interval [CI], 0.14–0.75; p = 0.009), smoking (OR, 3.23; 95% CI, 1.34–7.80; p = 0.009), preoperative hemoglobin level (OR, 0.68; 95% CI, 0.53–0.87; p = 0.002), and hemoglobin drop (OR, 1.93; 95% CI, 1.25–2.96; p = 0.003) as predictors for postsurgical flare. The area under the ROC curve was 0.801 (95% CI, 0.717–0.877; p < 0.001). The optimal cut-off point of probability greater than 0.453 predicted gout flare with a sensitivity of 76.8% and specificity of 73.2%. The prediction model may help identify patients at an increased risk of gout flare.