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Gout uric acid tophi hyperuricemia

Helen I Keen, Wendy A Davis, Erin Latkovic, Jocelyn J Drinkwater, Johannes Nossent, Timothy M E Davis
AIMS: The prevalence and consequences (articular and extra-articular) of hyperuricemia in type 2 diabetes, especially when asymptomatic (ASH), are incompletely understood. The aim of this study was to use ultrasonography to assess pathology associated with monosodium urate deposition in the joints of well-characterized hyperuricemic patients with type 2 diabetes. METHODS: A subset of 101 participants (mean age 70.4 years, 59.8% males, median diabetes duration 14...
April 2018: Journal of Diabetes and its Complications
Kuang-Hui Yu, Der-Yuan Chen, Jiunn-Horng Chen, Shih-Yang Chen, Shyh-Ming Chen, Tien-Tsai Cheng, Song-Chou Hsieh, Tsu-Yi Hsieh, Pai-Feng Hsu, Chang-Fu Kuo, Mei-Chuan Kuo, Hing-Chung Lam, I-Te Lee, Toong-Hua Liang, Hsiao-Yi Lin, Shih-Chang Lin, Wen-Pin Tsai, Gregory J Tsay, James Cheng-Chung Wei, Chung-Han Yang, Wen-Chan Tsai
Gout is an inflammatory disease manifested by the deposition of monosodium urate (MSU) crystals in joints, cartilage, synovial bursa, tendons or soft tissues. Gout is not a new disease, which was first documented nearly 5,000 years ago. The prevalence of gout has increased globally in recent years, imposing great disease burden worldwide. Moreover, gout or hyperuricemia is clearly associated with a variety of comorbidities, including cardiovascular diseases, chronic kidney disease, urolithiasis, metabolic syndrome, diabetes mellitus, thyroid dysfunction, and psoriasis...
April 2018: International Journal of Rheumatic Diseases
M C Cleophas, L A Joosten, L K Stamp, N Dalbeth, O M Woodward, Tony R Merriman
As a result of the association of a common polymorphism (rs2231142, Q141K) in the ATP-binding cassette G2 (ABCG2) transporter with serum urate concentration in a genome-wide association study, it was revealed that ABCG2 is an important uric acid transporter. This review discusses the relevance of ABCG2 polymorphisms in gout, possible etiological mechanisms, and treatment approaches. The 141K ABCG2 urate-increasing variant causes instability in the nucleotide-binding domain, leading to decreased surface expression and function...
2017: Pharmacogenomics and Personalized Medicine
Robert T Keenan
PURPOSE: This article outlines several important issues regarding the management of patients with gout. The topics discussed include best practices for gout based on the most current guidelines, opportunities for improving gout management, and current and emerging therapies for gout. METHODS: [PubMed and Google Scholar databases] were search for all articles and trials published before 2016, using the key terms [hyperuricemia, gout, tophi, joint erosion, joint damage, treatment guidelines, American College of Rheumatology (ACR), European League Against Rheumatism (EULAR), flare, comorbidity, epidemiology, adherence, serum uric acid (sUA), monosodium urate (MSU), <6 mg/dL, MSU crystal formation, as well as individual drug names and classes of treatments of interest (allopurinol, febuxostat, colchicine, non-steroidal anti-inflammatories (NSAIDs)]...
February 2017: Clinical Therapeutics
Elisa Delbarba, Vincenzo Terlizzi, Nadia Dallera, Claudia Izzi, Francesco Scolari
Already known to ancient Egyptians, gout is one of the first diseases which have been described as a clinical entity. To date, gout is the most common form of inflammatory arthritis. Gout is defined by the deposition of monosodium urate crystals within tissues, causing episodes of acute arthritis and the development of tophi, nephrolithiasis, and urate nephropathy. Hyperuricemia, i.e. levels of serum uric acid above 6.8 mg / dL(404mol/L), is a condition necessary, yet not sufficient for gout to develop. The increasing incidence of risk factors such as hypertension, obesity, and renal failure together with an ever-growing life expectancy has led in recent decades to a significant increase in gout prevalence, which has more than doubled when compared to the 1960s...
2016: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
Gary Ruoff, N Lawrence Edwards
Gout is a progressive, painful, debilitating form of inflammatory arthritis. It is caused by factors that elevate the concentration of serum uric acid (sUA), leading to hyperuricemia (sUA >6.8 mg/dL). Continued elevated sUA can result in monosodium urate (MSU) crystal deposition in joints and soft tissues, and can cause acute and chronic inflammation. The prevalence of hyperuricemia and gout has increased over the last few decades, likely due to an aging population, changes in lifestyles and diet, and an increase in gout-associated comorbidities...
September 2016: Postgraduate Medicine
Isabelle Ayoub, Salem Almaani, Sergey Brodsky, Tibor Nadasdy, Jason Prosek, Lee Hebert, Brad Rovin
BACKGROUND: It is well-established from autopsy studies that gouty tophi can form in the kidney, particularly in the renal medulla. Recently hyperuricemia has been identified as a risk factor for progression of chronic kidney disease (CKD). Because each collecting duct serves more than 2,000 nephrons, we postulated that obstruction or disruption of collecting ducts by medullary tophi may explain, at least in part, the association between hyperuricemia and progressive CKD. This work was done to determine the prevalence of medullary tophi in CKD patients...
February 2016: Clinical Nephrology
Ebru Hatice Ayvazoglu Soy, Emre Karakaya, Arzu Karatas Togral, Aydincan Akdur, Gokhan Moray, Mehmet Haberal
Gout is a chronic metabolic disease caused by disturbance of purine metabolism that leads to hyperuricemia. Hyperuricemia prevalence after renal transplant is reported as 19% to 84% in different studies. Tophaceous gout in renal transplant recipients is a consequence of increased hyperuricemia. Although tophus formation in skin and soft tissues is an indicator of chronic gout (also referred to as tophaceous gout), tophi may be the first sign of gout. In this study, we report a case of a 62-year-old male renal transplant recipient who had tophi as the first clinical sign of gout...
April 2015: Experimental and Clinical Transplantation
Raisa Mandokhel, Gwilym Pritchard, Jeremy Jones
No abstract text is available yet for this article.
February 2015: Rheumatology
Petr Němec
Gout represents a heterogeneous group of metabolic disorders characterized by production and deposition of sodium urate crystals in various tissues. The consequence of this deposition in musculoskeletal system causes gouty arthritis often presented by acute recurrent attack and development of chronic tophi. The most important risk factor is hyperuricemia which means higher level of acid uric in blood. Gout or hyperuricemia alone represents significant independent risk factor of all-cause and cardiovascular morbidity and mortality...
October 2014: Vnitr̆ní Lékar̆ství
Kuo-Li Pan, Jing-Chi Lin, Chun-Liang Lin, Mien-Cheng Chen, Shih-Tai Chang, Chang-Min Chung, Jen-Te Hsu
The purpose of our study was to evaluate the left ventricular (LV) and left atrial (LA) function in patients with gout. A total of 173 patients underwent a comprehensive Doppler-echocardiography examination. Participants were divided into four groups-Stage 0: control (n = 35), Stage I: asymptomatic hyperuricemia (n = 30), Stage II: gouty arthritis without tophi (n = 58), and Stage III: tophaceous gout (n = 50). Serum uric acid levels were not significantly different between stage I, II and III. Stage III patients demonstrated a higher ratio of the transmitral and myocardial peak early diastolic velocities (E/Em) (10...
2014: PloS One
L Pasina, A L Brucato, C D Djade, P Di Corato, S Ghidoni, M Tettamanti, C Franchi, F Salerno, S Corrao, A Marengoni, M Marcucci, P M Mannucci, A Nobili
PURPOSE: To investigate the prevalence of xanthine oxidase (XO) inhibitors prescription at admission and discharge in elderly hospital in-patients, to analyze the appropriateness of their use in relation to evidence-based indications, to evaluate the predictors of inappropriate prescription at discharge and the association with adverse events 3 months after hospital discharge. METHODS: This cross-sectional study, based upon a prospective registry, was held in 95 Italian internal medicine and geriatric hospital wards...
December 2014: European Journal of Clinical Pharmacology
Philip C Robinson, Simon Horsburgh
Gout is a common inflammatory arthritis precipitated by an inflammatory reaction to urate crystals in the joint. Gout is increasingly being recognised as a disease primarily of urate overload with arthritis being a consequence of this pathological accumulation. It is associated with a number of important co-morbidities including chronic kidney disease, obesity, diabetes and cardiovascular disease. The prevalence of gout is increasing around the world. Significant progress has been made in determining the genetic basis for both gout and hyperuricaemia...
August 2014: Maturitas
Danqiu Zhou, Yunqing Liu, Xinju Zhang, Xiaoye Gu, Hua Wang, Xinhua Luo, Jin Zhang, Hejian Zou, Ming Guan
BACKGROUND: Gout is a common type of arthritis that is characterized by hyperuricemia, tophi and joint inflammation. Genetic variations in the ABCG2 gene have been reported to influence serum uric acid levels and to participate in the pathogenesis of gout, but no further data have been reported in the Han Chinese population. METHODS: Peripheral blood DNA was isolated from 352 male patients with gout and 350 gout-free normal male controls. High-resolution melting analysis and Sanger sequencing were performed to identify the genetic polymorphisms V12M, Q141K and Q126X in the ABCG2 gene...
May 22, 2014: International Journal of Molecular Sciences
Huaxiang Wu, Jing Xue, Lu Ye, Qijing Zhou, Dan Shi, Rongzhen Xu
The aim of the study was to investigate the sensitivity and specificity of dual-energy computed tomography in the diagnosis of acute gouty arthritis, and the related risk factors for urate crystal deposition. One hundred ninety-one patients (143 with acute gouty arthritis and 48 with other arthritic conditions) were studied. All patients had acute arthritic attack in the recent 15 days and underwent dual-energy computed tomography (DECT) scan with the affected joints. The urate volume was calculated by DECT and the basic information of these patients was recorded at the same time...
July 2014: Clinical Rheumatology
Y Rommelspacher, P H Pennekamp, D C Wirtz
The following report deals with the case of a post-surgical gout after total hip arthroplasty. Before surgery, the patient was diagnosed with hyperuricaemia. Following the procedure, the patient developed superinfected gout tophi and several joint infections. Multiple surgeries were necessary to control the illness and to finally heal the infection. This study stresses pre-surgical hyperuricaemia as a severe illness and demonstrates a positive medical history of gout as a risk for post-surgical precipitation of uric acid...
February 2014: Zeitschrift Für Orthopädie und Unfallchirurgie
Xinfang Huang, Hui Du, Jieruo Gu, Dongbao Zhao, Lindi Jiang, Xinfu Li, Xiaoxia Zuo, Yi Liu, Zhanguo Li, Xiangpei Li, Ping Zhu, Juan Li, Zhiyi Zhang, Anbin Huang, Yuanchao Zhang, Chunde Bao
AIM: Febuxostat, a novel non-purine selective inhibitor of xanthine oxidase, has been identified as a potential alternative to allopurinol in patients with hyperuricemia. The purpose of this study was to compare the urate-lowering (UL) efficacy and safety of daily febuxostat and allopurinol in Chinese gout patients with hyperuricemia. METHODS: Gout patients (n = 512) with serum uric acid (sUA) concentrations of at least 8.0 mg/dL were randomized to receive daily febuxostat 40 mg or 80 mg or allopurinol 300 mg for 28 weeks...
July 2014: International Journal of Rheumatic Diseases
Kuo-Li Pan, Jing-Chi Lin, Chun-Liang Lin, Mien-Cheng Chen, Pey-Jium Chang, Ju-Feng Hsiao, Shih-Tai Chang, Chang-Min Chung
OBJECTIVE: The aim of the present study was to investigate the effect of gout on left ventricular (LV) diastolic function and left atrial volume (LAV). METHODS: A total of 173 patients were divided into four groups: control (n = 35), asymptomatic hyperuricaemia (n = 30), gouty arthritis without tophi (n = 58) and gouty tophi (n = 50). Patients underwent a comprehensive Doppler echocardiography examination to evaluate LV volume, systolic and diastolic function and LAV and function...
May 2014: Rheumatology
George L Bakris, Paul P Doghramji, Robert T Keenan, Steven H Silber
The prevalence of gout and hyperuricemia are on the rise in the United States corresponding with an increase in risk factors for these conditions, such as obesity, metabolic syndrome, and the use of diuretics. A progressive disorder, untreated gout can be debilitating and result in tophi, chronic arthropathy, and recurrent kidney stones. Although joint aspiration is needed for a definitive diagnosis, the majority of patients are diagnosed presumptively based on medical history and presentation with characteristic signs and symptoms...
January 2014: American Journal of Medicine
Rebecca M Seifried, Jefferson Roberts
This is a case report of a patient with treatment resistant gout who was prescribed pegloticase and developed a severe reaction. A 30-year-old Hawaiian-Filipino man presented with a nine-year history of gout that progressed from episodic monoarticular arthritis, treated with aspiration and corticosteroid injections, to more aggressive disease with more frequent attacks requiring escalation of therapy. He was treated with systemic corticosteroids, colchicine and nonsteroidal anti-inflammatory drugs, but then required allopurinol...
July 2013: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
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