Gout: Difference between revisions
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*Lifestyle - foods such as meat, [[alcohol]], sweetened drinks (with fructose) and seafood. Coffee, vitamin C and physical fitness ''decrease'' risk. | *Lifestyle - foods such as meat, [[alcohol]], sweetened drinks (with fructose) and seafood. Coffee, vitamin C and physical fitness ''decrease'' risk. | ||
*Genetics - there appears to be some genetic variability in uric acid production. There are a whole bunch of hereditary disorders too (you don't need to know them - they're really rare.) | *Genetics - there appears to be some genetic variability in uric acid production. There are a whole bunch of hereditary disorders too (you don't need to know them - they're really rare.) | ||
*Medical - [[metabolic syndrome]] involves gout in 75% of cases. [[Renal failure]], [[polycythaemia]], [[haemolytic anaemia]], [[psoriasis]] can all cause it. ([[Lead poisoning]] and organ [[transplants can too.) | *Medical - [[metabolic syndrome]] involves gout in 75% of cases. [[Renal failure]], [[polycythaemia]], [[haemolytic anaemia]], [[psoriasis]] can all cause it. ([[Lead poisoning]] and organ [[transplants]] can too.) | ||
===Clinical Features=== | ===Clinical Features=== | ||
Revision as of 11:48, 31 January 2012
Definition
A joint disease caused by high levels of uric acid in the blood.
Epidemiology
Pathophysiology
It is a disease of purine metabolism resulting in high uric acid levels. Uric acid is the final metabolite of this process.
When it is deposited in joints in high levels it forms crystals causing a localised inflammatory response.
Risk Factors
There are a variety of risk factors@
- Lifestyle - foods such as meat, alcohol, sweetened drinks (with fructose) and seafood. Coffee, vitamin C and physical fitness decrease risk.
- Genetics - there appears to be some genetic variability in uric acid production. There are a whole bunch of hereditary disorders too (you don't need to know them - they're really rare.)
- Medical - metabolic syndrome involves gout in 75% of cases. Renal failure, polycythaemia, haemolytic anaemia, psoriasis can all cause it. (Lead poisoning and organ transplants can too.)
Clinical Features
Can affect any joint but classically a swollen big toe.
Investigations
Standard blood tests but mainly uric acid levels.
Management
Short-term: colchicine +/- NSAIDs and steroids Long-term: allopurinol