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).
- 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.
- 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.
- Synovial Fluid Analysis
- Complete Blood Counts
- Serum Uric Acid
- Serum Creatinine
- Liver Function Tests,
- Urine Uric Acid
- 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:
- 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.
- Avoid Alcohol.
- Get your protein from low-fat dairy products.
- Limit your intake of meat, fish and poultry.
- Maintain a desirable body weight.