gout

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gout,

condition that manifests itself as recurrent attacks of acute arthritis, which may become chronic and deforming. It results from deposits of uric aciduric acid
, white, odorless, tasteless crystalline substance formed as a result of purine degradation in man, other primates, dalmatians, birds, snakes, and lizards. The last three groups of animals also channel all amino acid degradation into the formation of glycine, aspartic
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 crystals in connective tissue or joints. The presence of increased uric acid (a breakdown product of DNA) in the body distinguishes gout from other forms of arthritisarthritis,
painful inflammation of a joint or joints of the body, usually producing heat and redness. There are many kinds of arthritis. In its various forms, arthritis disables more people than any other chronic disorder.
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, although hyperuricemia alone, which often occurs in the complete absence of gout, is not thought to be the sole causative factor. About 95% of patients with this disorder are men, usually over 30. Gout is associated with obesity and a hereditary factor in some cases. Diet also has an affect on gout. Consumption of meat and seafood, which are high in purine (from which digestion produces uric acid), increase the risk of gout, and gout is worsened by kidney problems and drinking alcoholic beverages, which slow the excretion of uric acid. Beer, which is higher than other alcoholic beverages in purines, also has been shown to increase the risk of gout.

Gout usually begins with an acute attack of pain, inflammation, extreme tenderness, and redness in the affected joint—often the big toe and sometimes the ankle or knee. After repeated attacks the disease can cause the deposition of sodium urate crystals in the tissues about the joints, causing stiffness and deformity. The aim of treatment is to minimize the formation of uric acid crystals. A high liquid intake that increases daily urine output is usually recommended. An acute attack of gout is usually treated with nonsteroidal anti-inflammatory drugs, such as indomethecine or naproxen, or the corticosteroid prednisone. Colchicine, a preparation of the meadow saffronmeadow saffron
or autumn crocus,
perennial garden ornamental (Colchicum autumnale) of the family Liliaceae (lily family). Native to Europe and N Africa, it has escaped from gardens to meadows and fields in some parts of the United States.
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, used since 1763 for gout, is still used when symptoms are not controlled by other drugs. Allopurinol and other xanthine oxidase inhibitors are used to prevent gout attacks in patients with chronically elevated uric acid levels; they lower uric acid concentrations in the blood by inhibiting the conversion of xanthine to uric acid.

Gout

 

a disease caused by a disturbance of purine metabolism and by deposits of urates in the tissues, affecting mainly the joints and kidneys.

Gout constitutes 2.5 percent of all cases of joint diseases. Primary gout results from diet or from congenital metabolic disorders that cause such forms of the disease as familial gout. Secondary gout, which is less common, is caused by lead poisoning, by some diseases of the blood, and, less commonly, by other factors.

Gout chiefly affects middle-aged men. It is chronic or occurs in the form of acute recurrent attacks. An attack of gouty arthritis is marked by sudden pain, generally in the big toe. The pain rapidly intensifies and is accompanied by swelling and reddening. An attack can be provoked by trauma, excessive cold, or ingestion of alcohol or of food rich in purine bases and lasts from several hours to several days. After an attack, the pain subsides and the functions of the joint are restored. However, each new attack is longer and more intense. In most cases, gout gradually becomes chronic. Owing to the increased uric-acid concentration in the blood serum, urates are deposited in the tissues, generally near the external concha auriculae and around the joints, whose movements as a result become limited. The kidneys are frequently affected.

Gout is diagnosed on the basis of the following symptoms: acute attacks of painful swelling of a single joint, generally the big toe; deposits of urates (tophi); elevated uric-acid levels in the blood serum; the presence of uric-acid crystals in the synovia or synovial fluid; and characteristic changes in roentgenograms of joints.

Acute attacks of gout are treated with bed rest, colchicine, Rheopyrine, Ketazon, Indacin, or other agents capable of arresting the attacks. Chronic forms of the disease are treated with sodium carbonate, Anturane, Benemid, allopurinol, and other drugs that prevent the formation of uric acid or accelerate its excretion from the body. Drinking of copious fluids is recommended, and a diet low in calories and purines is prescribed. Consumption of alcohol, meat broths, liver, and kidneys is prohibited. Eggs and cheese are permitted in limited amounts, and fruit and groats are allowed. A stay at a health resort is recommended if the kidneys are not involved.

REFERENCE

Pikhlak, E. G. Podagra. Moscow, 1970.

V. M. CHEPOI

gout

[gau̇t]
(medicine)
A condition of purine metabolism resulting in increased blood levels of uric acid with ultimate deposition as urates in soft tissues around joints.

gout

a metabolic disease characterized by painful inflammation of certain joints, esp of the big toe and foot, caused by deposits of sodium urate in them
References in periodicals archive ?
Corticosteroid treatment was prescribed to patients with severe gouty arthritis or those who applied with acute attacks where the NSAII use was contraindicated.
Malignant fibrous histiocytoma arising in a gouty tophus at the second metacarpophalangeal joint.
However, prior to our recognition that our patient had CECS, case reports of carpal tunnel syndrome caused by gouty tophi [12-15] led us to consider the possibility that he had accumulated nonsynovial tophi (e.g., within the fascia) that precipitated ACS by reducing compliance of the fascia.
Three layers of glass in each of the four framed works provide a surface in which to build up transparent screen- printed images of the crowd and the ominous gouty hand.
According to the course of disease, gout is divided into four phases: (1) asymptomatic HUA, (2) acute attack of gouty arthritis, (3) intercritical gouty arthritis, and (4) chronic gouty arthritis.[27]
We prescribed benzbromarone, a potent uricosuric drug, to treat his gouty arthritis.
Symptoms of acute gouty arthritis typically include joint pain, swelling, and redness, with the knee being the third most commonly involved joint, behind the first metatarsophalangeal joint and ankle.
The syndrome in these patients develops in association with either tophaceous compression or gouty tenosynovitis.8,9 Entrapment neuropathies other than carpal tunnel syndrome in gout are rare and are generally reported in association with tophaceous compression.5 Cubital tunnel syndrome, the second most common entrapment neuropathy of the upper extremity, occurs due to compression of the ulnar nerve in the elbow.
Chronic gouty diseases clinically or radiologically evident joint erosions.
AggNETs were proposed to form the basis for gouty tophi [19], a long-described white material that typically appears at the end of acute attacks and is characteristic for the chronic phase of gout (Figure 2) [19, 37].