Gout

Abstract

Gout is a chronic disease of deposition of monosodium urate crystals, which form in the presence of increased urate concentrations. Although environmental factors contribute to hyperuricaemia, renal and gut excretion of urate is central to regulation of serum urate, and genetic factors are important. Activation of the NLRP3 inflammasome and release of interleukin 1β have key roles in initiation of acute gout flares. A "treat to target serum urate" approach is essential for effective gout management; long-term lowering of serum urate to less than 360 μmol/L leads to crystal dissolution and ultimately to suppression of flares. An allopurinol dose-escalation strategy is frequently effective for achieving treatment targets, and several new urate-lowering drugs are also available. Worldwide, rates of initiation and continuation of urate-lowering therapy are very low, and, consequently, achievement of serum urate targets is infrequent. Strategies to improve quality of gout care are needed.

Clinical and Ultrasonic Characteristics of 100 New Crystal Proven Gouty Patients in a Rheumatology Clinic

“…Reports on the joint involvement at onset of gout patients in primary care have not been found, but it must be assumed that the majority of patients initially present with intermittent monoarthritis [1,13]. The patients in the present hospital based study may represent a selected subgroup of patients with longer-standing and more severe disease than most patients seen in primary care.…”

“…It usually affects middle aged and elderly patients with predominance in males. Typically, gout presents as an intermittent monoartritis in the foot or ankle, but with prolonged and insufficiently treated hyperuricemia gout may develop into polyarticular disease [1].…”

Luteolin-rich chrysanthemum flower extract suppresses baseline serum uric acid in Japanese subjects with mild hyperuricemia

“…Gout is a disorder in which accumulation of needle-shaped uric acid crystals in peripheral tissues due to hyperuricemia [1]. Nonsteroidal anti-inflammatory drugs [2], steroids [3], and colchicine [4] are prescribed to suppress acute pain and inflammation, while xanthine oxidase (XOD) inhibitors such as allopurinol are used for reduction of high blood uric acid levels [5].…”

Electrochemical Biosensor for Simplified Determination of Salivary Uric Acid

“…The deposition of monosodium urate crystals in tissues can be found in hyperuricemia (6.8 mg/dl). (2) Because gout occurs mainly in middle-aged or elderly men, items related to their blood uric acid levels and dietary habits are one of the common daily topics in Japan. In addition, gout has recently been seen in young people, and it has been reported that the number of patients with gout is increasing.…”