Pathogenesis and Clinical Management of Gouty Arthritis.
Gout, the most common of the crystal arthritides is a result of disturbed uric acid metabolism and precipitation of urate crystals in extra cellular space of joints, periarticular tissue, bones and other organs. In the West, gout affects around 1% of adult men over 45 years of age. The estimated incidence being 0.6 to 2.1 per 1000 per year, with a prevalence of 9.5 to 13.5 per 1000 persons of all ages.1 The incidence of gout has been on rise globally; potentially attributable to recent shifts in diet, lifestyle, medical care, and increased longevity.2 Gout is three to four times more common in males than in pre-menopausal females; incidence in women increases after menopause and after the age of 60, approaches that in men.3 This update aims to highlight recent developments in understanding pathogenesis of gout along with current management strategies.
Consultant Rheumatologist and Sr Physician Apex Hospital, Jaipur; Former Professor and Head.
Renu
R
Saigal
Professor, Department of Medicine, SMS Medical College & Hospital, Jaipur, Rajasthan.
Abhishek
A
Agrawal
D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use; D015210:Arthritis, Gouty / Q000209:etiology / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D003078:Colchicine / Q000627:therapeutic use; D000072001:Diet, Healthy; D000069465:Febuxostat / Q000627:therapeutic use; D005440:Fluid Therapy; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000276:immunology / Q000378:metabolism / Q000628:therapy*; D007249:Inflammation; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D016540:Smoking Cessation; D014503:Urate Oxidase / Q000627:therapeutic use; D014527:Uric Acid / Q000378:metabolism; D014528:Uricosuric Agents / Q000627:therapeutic use*; D014969:Xanthine Oxidase / Q000037:antagonists & inhibitors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D006074:Gout Suppressants; D053590:Interleukin 1 Receptor Antagonist Protein; D014528:Uricosuric Agents; D000069465:Febuxostat; D014527:Uric Acid; D011092:Polyethylene Glycols; D000493:Allopurinol; D014969:Xanthine Oxidase; D014503:Urate Oxidase; C031545:Pegloticase; D003078:Colchicine