Gout  is  a  metabolic  disease  that  most  often  affects  middle-aged  to  elderly  men  and  postmenopausal  women.  It  results  from  an  increased  body  pool  of  urate  with  hyperuricemia. Hyperuricemia may  arise in a wide range of settings that cause overproduction or reduced excretion of uric acid or a combination of the two.


Gout  occurs  when  urate  crystals  accumulate  in  your  joint,  causing  the  inflammation  and  intense  pain  of  a  gout  attack.

Normally,  uric  acid  dissolves  in  your  blood  and  passes  through  your  kidneys  into  your  urine.  But  sometimes  either  your  body  produces  too  much  uric  acid  or  your  kidneys  excrete  too  little  uric  acid.  When  this  happens,  uric  acid  can  build  up,  forming  sharp,  needlelike  urate  crystals  in  a  joint  or  surrounding  tissue  that  cause  pain,  inflammation  and  swelling.

Your  body  produces  uric  acid  when  it  breaks  down  purines  —  substances  that  are  found  naturally  in  your  body.

Purines  are  also  found  in  meats,seafood,  alcoholic  beverages,  especially  beer,  and  drinks  sweetened  with  fruit  sugar  (fructose).

Risk  factors

  • Diet  rich  in  meats,seafood,  alcoholic  beverages,  especially  beer,  and  drinks  sweetened  with  fruit  sugar  (fructose).
  • Obesity.In  obese  person  body  produces  more  uric  acid  and  your  kidneys  have  a  more  difficult  time  eliminating  uric  acid.
  • High  blood  pressure.
  • Diabetes.
  • Metabolic  syndrome.
  • Heart  diseases.
  • Kidney  diseases.
  • Certain  medications.  The  use  of  Thiazide  Diuretics    commonly  used  to  treat  hypertension  and  low-dose  Aspirin  also  can  increase  uric  acid  levels.  Anti-rejection  drugs  prescribed  for  people  who  have  undergone  an  organ  transplant.
  • Family  history  of  gout.
  • Recent  surgery  or  trauma.


Acute arthritis—most frequent early clinical manifestation of gout. Usually initially affects one joint, but may be polyarticular in later episodes. The first metatarsophalangeal joint (podagra) is often involved. Acute gout frequently begins at night with dramatic pain, swelling, warmth, and tenderness.

Chronic arthritis—a proportion of gout pts may have a chronic nonsymmetric synovitis.

Untreated gout may cause deposits of urate crystals to form under the skin in nodules called tophi . Tophi can develop in several areas such as your fingers, hands, feet, elbows or Achilles tendons along the backs of your ankles.


Urate nephropathy—deposition of MSU crystals in renal interstitium and pyramids. Can cause chronic renal insufficiency.

Acute uric acid nephropathy—reversible cause of acute renal failure due to precipitation of urate in the tubules; pts receiving cytotoxic treatment for neoplastic disease.

Uric acid nephrolithiasis—responsible for 10% of renal stones.


  1. Synovial Fluid Analysis
  2. Complete Blood Counts
  3. Serum Uric Acid
  4. Serum Creatinine
  5. Liver Function Tests,
  6. Glucose
  7. Lipids
  8. Urine Uric Acid
  9. Joint x-rays—may demonstrate cystic changes, erosions with sclerotic margins in advanced chronic arthritis.


During symptom-free periods, these dietary guidelines may help protect against future gout attacks:

  1. Drink plenty of fluids. Stay well-hydrated, including plenty of water. Limit how many sweetened beverages you drink, especially those sweetened with high-fructose corn syrup.
  2. Avoid Alcohol.
  3. Get your protein from low-fat dairy products.
  4. Limit your intake of meat, fish and poultry.
  5. Maintain a desirable body weight.


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