Gout

Gout (GOWT) is a painful, inflammatory disease of the joints caused by deposits of crystals of uric (VUR-ik) acid.

What Is Gout?

* . In a patient with gout, however, the body either produces too much uric acid or excretes too little, and the excess crystallizes and accumulates in the joints and other tissues, causing inflammation and pain.

Gout comes in two types: primary and secondary. Primary gout results from excess uric acid that accumulates in the system of people with a genetic background of gout and strikes mainly men 40 years of age and older. Secondary gout occurs in situations in which the body is presented with large amounts of nuclear purines to metabolize because billions of excessive cells are turning over. This happens most frequently in acute leukemia * . When the leukemia responds to treatment, the uric acid concentrations subside and gout treatments can be stopped. Besides primary and secondary gout, doctors sometimes describe a patient's condition as tophaceous gout, a chronic form of the disease in which the uric acid crystals form hard masses, called tophi, around the joints.

Studies from 2010 and 2011 show that the prevalence of gout in the United States has been rising over the last 20 years and now affects 8.3 million Americans.




Gout





Gout
SOURCE: National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, U.S. Department of Health and Human Services. Table by GGS Information Services. © 2016 Cengage Learning®.

How Is Gout Diagnosed and Treated?

A VIVID DESCRIPTION

Gout has an unusually long written history. The Greek physician Hippocrates (c. 470–410 BCE) described this painful form of joint inflammation, or arthritis. One of the best known early accounts of the disease comes from English physician Thomas Sydenham (1624–1689), who also suffered from acute attacks of gout. In 1683, he wrote “Tractatus de podagra et hydrope,” in which he attempted to put down on paper the symptoms of such an attack:

The victim goes to bed and sleeps in good health. About 2 o'clock in the morning, he is awakened by a severe pain in the great toe; more rarely in the heel, ankle, or instep. This pain is like that of a dislocation, and yet the parts feel as if cold water were poured over them. Then follow chills and shiver and a little fever. The pain which [is] at first moderate becomes more intense. With its intensity, the chills and shivers increase. After a time this comes to a full height, accommodating itself to the bones and ligaments of the tarsus and metatarsus [the ankle and feet]. Now it is a violent stretching and tearing of the ligaments—now it is a gnawing pain, and now a pressure and tightening. So exquisite and lively meanwhile is the feeling of the part affected, that it cannot bear the weight of bedclothes nor the jar of a person walking in the room.




Gout, a form of acute arthritis, most commonly occurs in the big toe. It is caused by high levels of uric acid in the blood, in which urate crystals settle in the tissues of the joints and produce severe pain and swelling.





Gout, a form of acute arthritis, most commonly occurs in the big toe. It is caused by high levels of uric acid in the blood, in which urate crystals settle in the tissues of the joints and produce severe pain and swelling.
Illustration by Electronic Illustrators Group. © 2016 Cengage Learning®.

See also Arthritis

Resources

Books and Articles

Bakalar, Nicholas. “An Upside to Gout: It May Offer Alzheimer's Protection.” New York Times, March 3, 2015. http://well.blogs.nytimes.com/2015/03/03/an-upside-to-gout-it-may-offer-alzheimersprotection/?_r=0 (accessed October 21, 2015).

Kelly, Janice, K. “Gout Incidence Increasing, but Most Patients Go Untreated.” Medscape, January 17, 2014. http://www.medscape.com/viewarticle/819441 (accessed October 21, 2015).

Websites

Gout Education. “What Is Gout?” Gout and Uric Acid Education Society. http://gouteducation.org/patient/what-is-gout/ (accessed July 14, 2015).

Organizations

American College of Rheumatology. 2200 Lake Blvd NE, Atlanta, GA 30319. Telephone: 404-633-3777. Website: https://www.rheumatology.org/ (accessed October 21, 2015).

Arthritis Foundation. PO Box 7669, Atlanta, GA 30357-0669. Toll-free: 800-283-7800. Website: http://www.arthritis.org (accessed October 21, 2015).

National Institute of Arthritis and Musculoskeletal and Skin Diseases. 1 AMS Circle, Bethesda, MD 20892-3675. Toll-free: 877-226-4267. Website: http://www.niams.nih.gov (accessed October 21, 2015).

* urine is the liquid waste material secreted by the kidneys and removed from the body through the urinary tract.

* leukemia (loo-KEE-me-uh) is a form of cancer characterized by the body's uncontrolled production of abnormal white blood cells.

Disclaimer:   This information is not a tool for self-diagnosis or a substitute for professional care.

(MLA 8th Edition)