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Gout - Highlights
- Highlights
- Introduction
- Symptoms
- Causes and Risk Factors
- Triggers
- Diagnosis
- Treatment: Acute Gout Attack
- Treatment: Preventing Attacks
- Lifestyle Changes
- Complications
Description
An in-depth report on the causes, diagnosis, treatment, and prevention of gout.Alternative Names
Hyperuricemia
Highlights:
Medication News
In December 2008, the Food and Drug Administration agreed to grant Puricase, a uric acid-reducing drug, priority review for possible approval.
Research News
- A new research identified three genetic locations associated with the body's uric acid handling and gout.
- A large study found that people with gout are at an increased risk of having metabolic syndrome. Metabolic syndrome is a collection of problems, such as abdominal obesity, high blood pressure, and low "good" cholesterol. This syndrome increases a person's risk of heart disease and stroke.
Types of Gout
There are two types of gout -- primary and secondary.
- Primary gout: The cause is usually unknown. However, primary gout is likely the result of a combination of genetic, hormonal, and dietary factors.
- Secondary gout: Secondary gout is caused by medications or medical conditions that cause an increase in the serum (blood) levels of uric acid.
Risk Factors
Risk factors for gout include:
- Advancing age
- Male gender
- Family history of the condition
- Obesity
- Use of certain drugs, including diuretics, low-dose aspirin, cyclosporine, or levodopa
- Binge drinking
- Lead toxicity
- Organ transplants
- Thyroid problems
Symptoms of a Gout Attack
Symptoms of a gout attack include:
- Severe pain at and around the joint
- May feel like "crushing" or a dislocated bone
- Walking or even the weight of bed sheets may be unbearable
- Usually takes 8 - 12 hours to develop
- Attacks often begin late at night or early in the morning and may wake you up
- Swelling that may extend beyond the joint
- Red, shiny, tense skin over the affected area, which may peel after a few days
- Chills and mild fever, loss of appetite, and feelings of ill health
Resources
- www.niams.nih.gov -- National Institute of Arthritis and Musculoskeletal and Skin Diseases
- www.rheumatology.org -- American College of Rheumatology
- www.arthritis.org -- The Arthritis Foundation
- www.gouteducation.org -- The Gout & Uric Acid Education Society
References
Choi HK, Ford ES, Li C, Curhan G. Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2007;57(1):109-15.
Dehghan A, Köttgen A, Yang Q, et al. Association of three genetic loci with uric acid concentration and risk of gout: a genome-wide association study. Lancet. 2008;372(9654): 1953-1961.
Huang HY, Appel LJ, Choi MJ et al. The effects of vitamin C supplementation on serum concentrations of uric acid: results of a randomized controlled trial. Arthritis Rheum. 2005 Jun;52(6):1843-7.
Keith MP, Gilliland WR. Updates in the management of gout. Am J Med. 2007;120(3):221-224.
Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006 Aug;54(8):2688-96.
Underwood M. Diagnosis and management of gout. BMJ. 2006;332(7553):1315-9.
Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1301-11.
Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-24.
Zhang YQ, Chaisson CE, Chen CA, McAlindon TE, Hunter DJ. High Humidity and High Temperature Increase the Risk of Recurrent Gout Attacks: The Online Case-crossover Gout Study. Presentation Number 707. American College of Rheumatology Annual Scientific Meeting, Washington, DC, November 2006.
- Reviewed last on: 2/14/2009
- Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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