Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018099 (gout)
 5,192 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 60-year-old man presented with polyarthralgias, a psoriasiform rash, and severe elbow pain. Peripheral blood smear and bone marrow biopsy established a diagnosis of myelofibrosis with myeloid metaplasia. Biopsy of the skin lesions revealed a nonspecific dermatitis. The clinical presentation was inconsistent with psoriatic arthritis, and there was no evidence for associated gout or collagen-vascular disease. Histological examination of tissue taken at the time of synovectomy indicated elbow arthritis to be due to myeloid metaplasia involving the synovial membrane.
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PMID:Arthritis due to synovial involvement by extramedullary haematopoiesis in myelofibrosis with myeloid metaplasia. 684 65

The authors carried out an open noncomparative study to evaluate the anti-inflammatory therapeutic activity of piroxicam in 40 adult patients suffering from acute gout. The patients ranged in age from 28 to 68 years (the average age was 51.6 years) overall, 21 men and 19 women participated in the trial. All of the patients had their disease for more than one year and they were receiving treatment with Benziodarone, 100 mg per day when the drug was discontinued from clinical use in Brazil. All of these patients subsequently experienced aggravation of their disease and had an acute attack of gout. Each patient was given piroxicam, 40 mg, in a single dose on the first day and two divided doses of 20 mg for the following five days. The affected joints were: elbow, knee, ankle and hallux. Severity of pain at rest, severity of pain on movement, tenderness, swelling, redness, heat and restriction of movement were evaluated. By the sixth day of the trial, good or total remission was observed in all patients. Overall evaluation of efficacy showed excellent and good results in 81.6% of the patients. Tolerability was excellent and good in 92.5%. All adverse reactions that occurred during the use of piroxicam therapy were noted. Five patients showed mild side effects, such as pyrosis, nausea and headache, and two patients had severe side effects (skin rash, gastric disturbance) that necessitated withdrawal from therapy. Finally, statistical analysis demonstrates that piroxicam is highly efficacious in the treatment of acute gout.
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PMID:Use of piroxicam in the treatment of acute gout. 686 11

In two monitored-release studies of feprazone (Methrazone), one in hospital and the other in general practice and involving a total of about 4,000 patients, there were 343 patients with a variety of sero-negative rheumatological conditions or soft tissue lesions. The diagnoses included spondylosis, ankylosing spondylitis, psoriatic arthritis, capsulitis, frozen shoulder, polymyalgia rheumatica and gout. Most of the patients were classified as moderately or severely affected. Feprazone in a dose of 200 mg thrice daily appeared to benefit about 60% of patients during a course of 8 weeks of therapy. No serious adverse reactions directly attributable to the drug were recorded. About 20% of patients stopped treatment because of side-effects, usually gastro-intestinal disturbance or rash. Two patients experienced a marked fall in platelet count which might have been due to the drug, but neither developed any signs of thrombocytopenic purpura.
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PMID:Miscellaneous rheumatological conditions treated in monitored-release studies with feprazone. 697 94

A 30-year-old Mexican woman had rash, deep ulcerations of her lower extremities, and debilitating polyarthritis. Her disorder simulated rheumatoid vasculitis, but serum rheumatoid factor was absent. The diagnosis of gout was confirmed by uric acid crystals in joint fluid and skin biopsy specimens and by x-ray crystallography. The age and sex were unusual for a patient with gout, and she had none of the commonly associated metabolic defects. This unique presentation for urate arthropathy needs further study.
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PMID:Gout masquerading as rheumatoid vasculitis. 818 55

Pustular drug eruptions are uncommon and usually present with an acute illness. A 75-year-old-woman presented with a widespread pruritic pustular erythematous skin rash. She was otherwise well and had been commenced on allopurinol for gout 3 weeks before developing the rash. A skin biopsy was consistent with a pustular drug eruption, with features of acute generalized exanthematous pustulosis (AGEP). Allopurinol was the probable causative agent and withdrawal resulted in resolution of her eruption within 6 weeks. A diagnosis of AGEP was considered; however, this patient did not fulfil the diagnostic criteria.
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PMID:Allopurinol-induced pustular eruption: an unusually mild case. 1198 73

A clinical evaluation of phenylbutazone and Butapyrin(R) (a mixture of phenylbutazone and aminopyrine) was made in 409 patients who had a variety of rheumatic diseases. Preliminary European claims were substantiated.In gout a specific favorable effect was brought about by phenylbutazone alone. Effects equivalent to the previously reported favorable response to Butapyrin (Irgapyrin) were observed when its constituent phenylbutazone was used alone. The drug had a suppressive effect in a high percentage of patients with rheumatoid arthritis, ankylosing spondylitis, arthritis with psoriasis and mixed arthritis (rheumatoid arthritis plus osteoarthritis). Favorable effect in peritendinitis of the shoulders, osteoporosis of the spine and acute lumbosacral strain also was noted. Toxicity resulted in discontinuance of medication in 10 per cent of patients with each drug. Manifestations of toxicity generally included fluid retention, nausea and rash, but there were several instances of transitory leukopenia and anemia. There was one instance of agranulocytosis with Butapyrin but none with phenylbutazone.dagger Aggravation of peptic ulcer occurred in ten patients with hemorrhage in two. Generally the toxicity was of a low order as compared with that of other drugs having an antirheumatic effect.
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PMID:Phenylbutazone (butazolidin) and butapyrin; a study of clinical effects in arthritis and gout. 1300 82

Phenylbutazone (Butazolidin(R)), one of the newer antirheumatic drugs, while providing varying degrees of symptomatic relief in various types of rheumatism, may also cause serious toxic side effects. It is most effective in acute gout, and slightly less so in rheumatoid arthritis, of both the spondylitic and peripheral types. Its use in degenerative arthritis is not indicated. Its toxic side effects include gastrointestinal upsets, edema, rash, stomatitis, purpura, hematuria, agranulocytosis and reactivation of peptic ulcer. Several fatalities have been reported. It is, however, a valuable drug if used properly. Extreme caution should be exercised in selection of patients, in administration of the drug and in continuous observation of patients receiving it.
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PMID:Phenylbutazone: an evaluation of its use. 1308 20

The negative association between gout and rheumatoid arthritis is widely accepted, and gout is also speculated to be rare in systemic lupus erythematosus (SLE), as only a few sporadic cases have been reported. From 1985 to 2001 we encountered 15 lupus patients at Chang-Gung Memorial Hospital, including two with lupus-scleroderma and one with lupus-scleroderma-polymyositis overlap syndrome coexisting with gout. This study retrospectively analyses the clinical and laboratory characteristics of these patients. A lower female predominance is found, and most patients developed gout after the onset of SLE, although gout preceded SLE in two cases. Measurement of serum uric acid and 24-h urine uric acid found all of the patients to be hyperuricaemic and underexcretors of uric acid. Furthermore, most of the patients (14/15) were receiving diuretics. Also, many had hypertension and serious cardiovascular diseases. Renal impairment during gouty attacks seemed to be a predisposing factor for developing end-stage renal disease. Gouty arthritis usually occurred during relative SLE inactivity, podagra was frequent, and tophi were found in a few patients. Compared with the unselected population of SLE patients, the cases studied here had a higher incidence of chronic arthritis, malar rash, haematologic disorder, photosensitivity, serositis and neurologic disorder. Renal disease in the patients sampled was frequently membranous nephropathy.
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PMID:Gout in systemic lupus erythematosus and overlap syndrome - a hospital-based study. 1457 59

Allopurinol is frequently used for the treatment of hyperuricemia and gout. Sometimes, a life-threatening reaction develops, as is illustrated by the following case report. We describe a 60-year-old male patient who was treated with allopurinol because of asymptomatic hyperuricemia, and he was presented with fever, skin rash, eosinophilia, worsening renal function and vanishing bile duct syndrome. In this report, we discussed vanishing bile duct syndrome as a serious side effect of allopurinol, and we briefly reviewed the etiology, prevention, and treatment modalities for vanishing bile duct syndrome.
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PMID:[A case of vanishing bile duct syndrome associated with hypersensitivity to allopurinol]. 1578 88

Hyperuricemia is present in approximately 5% of the population, the vast majority of whom are asymptomatic and at no clinical risk. Complications, including renal calculi, uric acid nephropathy and gout, occur in a small proportion of patients. Allopurinol, an analog of hypoxanthine, has been widely used in clinical practice for over 30 years for the treatment of hyperuricemia and gout. Two percent of patients taking this medication develop a mild exanthema. A syndrome characterized by exfoliative dermatitis, hepatitis, interstitial nephritis and eosinophilia has been described previously. Termed allopurinol hypersensitivity syndrome, its etiology is related to the accumulation of one of the allopurinol metabolites, oxypurinol; clearance of oxypurinol is decreased in the setting of renal insufficiency and the use of thiazide diuretics. The term DRESS syndrome (Drug Rash with Eosinophilia and Systemic Symptoms) was recently introduced to describe a disorder associated with various drugs or viral infections and characterized by similar features. The pathophysiology of allopurinol-induced hypersensitivity, clinical presentation and treatment are reviewed.
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PMID:Allopurinol-induced DRESS syndrome. 1625 49


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