title: Polyarticular gout attacks following cerebrovascular accidents: is hemiparesis in fact protective? 2 cases and a review of the literature.
abstract: Cerebrovascular disease appears to have implications on rheumatic diseases, including gout. Accumulating evidence suggests that hemiparesis exerts a protective effect against gout via the down-regulation of mechanical and neural modulators of inflammation in neurologically impaired extremities. We present 2 divergent cases of unilateral gout following cerebrovascular events. One patient with a hemorrhagic stroke developed polyarticular gout only on the ipsilateral side to his hemiparesis, while another patient with basilar artery thrombosis and locked-in syndrome suffered a polyarticular gout flare only on the side that had regained limited function. As suggested by these cases, the effect of hemiparesis on gout is complex. Further insight into the interplay between gouty flares and hemiparesis may lead to novel therapeutic strategies for gout.
authors.affiliation: New York University School of Medicine, New York University Langone Medical Center, New York, NY, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Hsiao
authors.forename: Maksim
authors.initials: M
authors.lastname: Vaynrub
authors.forename: Victoria
authors.initials: V
authors.lastname: Furer
authors.forename: Jonathan
authors.initials: J
authors.lastname: Samuels
mesh_terms: D002490:Central Nervous System / Q000503:physiopathology; D006073:Gout / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000150:complications* / Q000503:physiopathology; D012216:Rheumatic Diseases / Q000517:prevention & control*; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D013927:Thrombosis / Q000150:complications* / Q000503:physiopathology; D014527:Uric Acid / Q000378:metabolism
chemical_list: D014527:Uric Acid