Disease Known as Gout, Including

¶ … disease known as "Gout," including its symptoms, diagnosis, causes and risk factors, prevention and treatment.

Symptoms: Gout is a common form of arthritis (inflammation of the joints) which is characterized by severe pain, swelling, stiffness, and redness in the affected joint.1 Tenderness of the affected area is another symptom of the disease and at times even a blanket touching the skin over the affected joint can be unbearable.2 In acute gout attacks, patients can also develop fever. Gout usually affects one or two joints of the feet or the ankle at a time; most commonly the ball joint of the big toe. The first attack of gout typically occurs suddenly and then disappears, often without treatment within a few hours, days, or weeks, depending on the severity of the attacks. The interval between the initial attacks of gout may be months or even years but tend to occur more frequently until the disease reaches a chronic stage. Chronic gout may lead to decreased kidney function, and kidney stones, and kidney failure.1

Diagnosis: Gout is diagnosed through a combination of clinical observation and tests. If gout is suspected, the patient is tested for hyperuricemia, i.e., uric acid levels, since most people with gout have hyperucemia at some stage of their disease. Other blood tests such as a full blood count, electrolyte level, and renal function are performed to eliminate other forms of arthritis. The definitive diagnosis of gout is made by light microscopy of the joint fluids that demonstrates the presence of monosodium urate crystals in the synovial fluid. Absence of urate crystals does not, however, completely rule out the possibility of gout. The patient's symptoms as well as the physical presence of chalky, sodium urate deposits (tophi) around joints are also indicative of the presence of gout.1

Causes and Risk Factors: The exact cause of gout is not known although it is believed to be linked to defects in purine metabolism. Purine is an organic compound which is metabolized into uric acid by the body and impaired metabolism leading to excess production or decreased excretion of uric acid may cause gout.

A number of risk factors have been identified as possible causes of gout. For example, genetics may play an important role in determining a person's predisposition towards a disease as about 18% of people with gout have a family history of the disease.1 Gender and age are also important risk factors since gout is more common in men and adults. Obesity and excessive drinking of alcohol, which interferes with removal of uric acid from the body, are also important risk factors. Eating foods rich in purines and exposure to lead are other risk factors that may cause or aggravate gout. Certain medicines that interfere with the body's ability to excrete uric acid are also listed as risk factors for the disease. These include diuretics, low-dose aspirin, niacin, cyclosporine (a medicine used to suppress the body's immune system) and tuberculosis medications such as pyrazinamide and ethambutol. Diseases such as leukemias, lymphomas, and hemoglobin disorders cause excess production of uric acid and may cause gout too. 2