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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Gouty arthritis in females is relatively infrequent, although the sex ratio may be somewhat altered in different races. A positive family history is relatively prevalent among females whose onset of gout is premenopausal. In those patients with a postmenopausal onset, the incidence of diuretic-associated gout is high. The bimodal distribution of serum urate might be related to some variance of genetic transmission in female gout. Hypertension and coronary heart disease are common coexisting conditions, as is true of gouty arthritis in males. Chronic urinary tract infection dating from previous pregnancies is a frequent complication. The relative prevalence of proteinuria and diminished renal function leads to increased hyperuricemia, with a tendency to a low urinary uric acid output. This explains in part the higher incidence of extensive tophaceous deposition but lower incidence of renal calculi. Diuretics are associated with a higher urine pH, likewise, they reduce the urinary uric acid excretion. This also may contribute to the lower incidence of renal calculi. There may be some statistical support for the low fertility rate among the gouty females. Only two females became pregnant after the onset of gouty arthritis. All other pregnancies occurred before the onset of arthritis. Even then, abnormal pregnancies were relatively frequent. Some hormonal malfunction among the gouty females cannot be discounted. Both renal calculi and tophi are frequent in female gout associated with blood dyscrasias. They may manifest early, preceding the first attack of acute gouty arthritis. In both the male and female secondary gout, the primary underlying disease governs the uric acid metabolism and the clinical symptomatology of gout. The predominant role in pathogenesis is the excessive rate of uric acid production, and its disposal is governed by the different stages of the underlying disease and the treatment. Thus, secondary gout in females appears to be somewhat different from primary gout in females, but not different from secondary gout in males.
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PMID:Some unusual features of gouty arthritis in females. 83 22

During observation of 250 patients with gout in the Institute of Rheumatology in Warsaw in the years 1962-1975 several patterns of joint destruction stages in gouty arthropathy have been recognized on the basis of serial roentgenograms. Histological examination of joints and bones suggests with a considerable probability that the progression of arthropathy depends on the extension of sodium urate deposits in articular tissues. Histological documentation of consecutive stages of joint distruction corresponding to the above mentioned patterns of radiological changes is presented.
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PMID:Consecutive stages of arthropathy progression in patients with gout. 86 Jun 4

The arthritis urica is defined as a relatively rare, at the same time facultative symptom of different metabolic and other disturbances (primary and secondary gout). As a rule it is observed only several years of the beginning of the hyperuric-anemia nearly exclusively in males and is only one form of manifestation of the wide-spread complex gout syndrome. It is proposed to supplement the criteria for gout or arthritis urica of Rome 1961 and New York 1966 by new knowledge on the uncharacteristic gouty arthropathy. It is particularly referred to method problems of the determination of uric acid in the serum.
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PMID:[Diagnostic problems of gout]. 99 60

To evaluate the frequency and the pathogenesis of hyperuricemia and gout during cyclosporine therapy, we studied renal-transplant recipients who were treated with either cyclosporine and prednisone (n = 129) or azathioprine and prednisone (n = 168). Among the patients with stable allograft function and serum creatinine concentrations below 265 mumol per liter, hyperuricemia was more common in the cyclosporine group than in the azathioprine group (84 percent vs. 30 percent; P = 0.0001). Gout developed in nine patients (7 percent) in the cyclosporine group, but no episodes occurred in the azathioprine group. Serum urate levels became elevated in 90 percent of the patients in the cyclosporine group who were treated with diuretics, as compared with 60 percent of those not treated with diuretics (P = 0.001); in the azathioprine group, the corresponding values were 47 percent and 15 percent (P = 0.0001). Serum urate levels did not correlate with trough blood cyclosporine levels in a selected subgroup (n = 40) of patients from the cyclosporine group, who were studied from 4 to 96 weeks after transplantation. Detailed studies of urate metabolism in six cyclosporine-treated patients revealed normal turnover rates for urate and decreases in creatinine and urate clearance, as compared with seven control subjects. We conclude that hyperuricemia is a common complication of cyclosporine therapy and is caused by decreased renal urate clearance. Gouty arthritis is the cause of considerable morbidity among renal-transplant recipients who receive cyclosporine.
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PMID:Cyclosporine-induced hyperuricemia and gout. 266 17

The 99mTc hydroxy methylene diphosphonate scintigraphic findings of both hands are correlated to the radiographic findings in a patient with a 30-year history of gouty arthropathy. Scintigraphic differentiation of the type of arthritis on the basis of uptake pattern is difficult. However, the findings of rheumatoid arthritis are confined to the joints and usually the involvement is symmetrical. With gout there is a tendency toward asymmetrical, bilateral, multifocal joint involvement with areas of intense abnormal uptake; because of the associated soft tissue swelling, the intense uptake usually extends beyond the involved joints.
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PMID:99m-Tc HMDP bone scintigraphic findings of gouty arthropathy of both hands: extending soft tissue uptake adjacent to the joints. 341 89

Gout is a disease linked to altered uric acid metabolism with increased uric acid concentration in the blood, the deposition of sodium urate crystals in certain tissues and abscesses. Uric acid derives from ex novo purinogenesis and the catabolism of cellular and alimentary nucleic acids. It is eliminated by uricolysis mainly in the intestines and renal excretion. The restriction of dietary protein purines, fats and calories reduces uricemia and explains the relationship between gout and diet. In Europe 5-18% of adult males suffer from uricemia with gout occurring in 0.5-1%. The incidence among females is much lower. The clinical picture presents an acute phase with a gouty abscess linked to the swollen joints caused by sodium urate crystals and a chronic phase characterised by gouty tophi and chronic gouty arthropathy. Treatment of the acute phase in which ample use is made of colchicine must be followed by medical and dietary treatment of the chronic condition.
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PMID:[Arthropathies and nutrition: gout]. 372 25

A 62-year-old man with a typical history of gout was admitted to the hospital with left-sided hemiplegia. His serum uric acid level was 10.3 mg/dL, his partial thromboplastin time was 198 s, and his Hageman factor (factor XII) coagulant activity and antigen were less than 1% of normal. Aspiration of synovial fluid from his inflamed knee disclosed urate crystals and abundant leukocytes but an absence of Hageman factor antigen. The presence of acute gouty arthritis in a patient with Hageman trait challenges the role of Hageman factor in the pathogenesis of gouty arthropathy.
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PMID:Classic gout in Hageman factor (Factor XII) deficiency. 710 39

Ten generations of selection for uricemia and articular gout have led to the development of the HUA line which is characterized by a threefold increase in plasma level of uric acid when compared to the control LUA line, even when fed diets containing normal levels of protein. Articular gout results in many cases, especially among adult males fed a normal breeder diet. Restriction protein level of the diet delays or prevents the development of articular gout in mature males of the HUA line. The data suggest that relatively few genes are responsible for the defect in renal transport of uric acid which underlies the uricemia and gout. The association of lower levels of uric acid with dominant white plumage color suggests a linkage of a major recessive gene for the I gene. Ambient temperature, because of its effect on food consumption, influences the level of uric acid in blood plasma. The HUA line and its control (LUA line), both sex-linked dwarfs, would appear to provide an excellent animal model for the experimental study of gout in man.
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PMID:Hereditary uricemia and articular gout in chickens. 739 46

A 36-year-old Chinese man presented with clinical and biochemical features of renal failure. He has had recurrent attacks of acute gouty arthritis since the age of 15 years. Present radiographic features of extensive chronic tophaceous gout included soft tissue masses, calcification, and typical erosions in the hand and feet. The condition of familial juvenile gouty nephropathy is discussed. Awareness of juvenile-onset gouty arthropathy should lead to early investigation, diagnosis and appropriate management. The complication of associated nephropathy may potentially be prevented.
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PMID:Clinics in diagnostic imaging (2). Juvenile gouty arthropathy with associated nephropathy. 757 Jan 44

Therapeutic effect of hemodialysis on gouty arthritis and tophi in 2 patients with chronic renal failure (CRF) is described. One patient was 74-year-old man with CRF due to benign nephrosclerosis, and had severe secondary gout. There were many tophi in metatarsophalangeal joints of the fingers and toes. Another patient was 44-year-old man with CRF probably due to familial gout. He had many tophi in elbows, knees, wrists, fingers and toes. In both cases initiation of hemodialysis treatment, at first temporally exacerbated gouty arthritis, but thereafter gradually eliminated the tophi. From these results, dialysis treatment is considered to be quite efficient method of treatment for gouty arthritis and tophi in patient with CRF. Gouty arthritis in CRF patient, which does not respond to the conservative therapy, should be considered to be one of the indices for commencement of hemodialysis.
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PMID:[Therapeutic effect of hemodialysis on gouty arthritis and tophi in 2 patients with chronic renal failure]. 837 92


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