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

The authors have examined the incidence of the rheumatoid factor in the serum of a group of 100 patients, 95 males and 5 females, suffering from gout, of whom only 6 suffered from chronic gout. The rheumatoid factor in the serum was measured by RA-test (1:40) and by Waaler-Rose test (1:32). The rheumatoid factor was not present in the examined subjects and so we can state that such serum parameter does not represent, for its negativity, a laboratory index of any evidence in the gout and it doesn't represent a reason for diagnostic doubts with other forms with the rheumatoid factor in the serum.
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PMID:[Determination of the rheumatoid factor in gouty patients]. 646 66

The majority of paired sera and synovial fluids from 21 patients with rheumatoid arthritis produced a rapid chemiluminescent response when incubated with human neutrophils. Synovial fluid gave considerably higher responses than the paired serum specimen. In contrast little or no response was found with paired sera and joint fluid taken from patients with gout, psoriasis, and osteoarthritis and with sera from healthy donors. A similar chemiluminescent response was observed when neutrophils were preincubated with large aggregates of heated human gammaglobulin (HAGG), which were used as a model of immune complexes. Smaller nonreactive aggregates of gammaglobulin became reactive after preincubation with a purified monoclonal rheumatoid factor (mRF) which had a high avidity for aggregated IgG. The addition of this monoclonal rheumatoid factor also caused enhancement of chemiluminescence by rheumatoid sera. Further evidence suggesting that the active material found in these rheumatoid specimens contained complexed immunoglobulin was obtained by indirect immunofluorescence. Neutrophils developed intracellular immunoglobulin inclusions after preincubation in reactive rheumatoid sera but not with nonreactive or normal sera. However, activation of neutrophil chemiluminescence by rheumatoid specimens did not correlate significantly with levels of rheumatoid factor or immune complexes suggesting that the activating complexes were of a particular type. In conclusion we have shown the direct activation of neutrophil chemiluminescence by rheumatoid sera synovial fluid and suggest that the activation is caused by large IgG-containing immune complexes. It is possible that this activation may have important implications in the immunopathogenesis of the rheumatoid inflammatory process.
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PMID:Direct activation of neutrophil chemiluminescence by rheumatoid sera and synovial fluid. 684 60

Subcutaneous nodules and rheumatoid factor (RF) are criteria used to diagnose rheumatoid disease. Their presence correlates with disease severity and poorer prognosis. They have been reported, however, in patients with little arthritis and no systemic disease. We studied four such patients, in whom (1) RF was present in high titer; (2) nodules were often extensive (nodulosis) and involved elbows, hands, and feet, with a predilection for tendons; and (3) roentgenograms showed large, subchondral bone cysts without cortical erosion of correlation with nodule location. The conditions of three of these patients had been previously misdiagnosed as gout or xanthoma. Our findings were similar to those in seven other patients described in earlier reports. We suggest that nodulosis, bone cysts, and elevated RF with little active arthritis constitute a relatively benign variant of rheumatoid disease.
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PMID:Rheumatoid nodulosis. A relatively benign rheumatoid variant. 722 42

We report a case of definite rheumatoid arthritis (RA) by ARA criteria with a high titer rheumatoid factor and coexisting gout as demonstrated by biopsy-proven monosodium urate crystals. Two other cases meeting ARA criteria for RA who probably had gout as their sole disease are described. Criteria for the definition of coexistent RA and gout are proposed.
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PMID:The coexistence of gout and rheumatoid arthritis: case reports and a review of the literature. 740 Oct 66

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

Many musculoskeletal complaints are accompanied by classic signs and symptoms that can be readily diagnosed by the primary care physician. Others are much less obvious and present a diagnostic challenge. In the office evaluation of patients with musculoskeletal complaints, the history is the most informative element. Least helpful are laboratory tests. Although erythrocyte sedimentation rate (ESR), rheumatoid factor, and other widely available tests are sensitive to the presence of rheumatic diseases, they are not specific for any of them. In the initial office evaluation, helpful points of differentiation include the number of joints involved, their location, and, when multiple joints are involved, whether they are symmetric or asymmetric. An acute monarthritis is associated mainly with trauma, infection, or a crystal-induced synovitis such as gout or pseudogout. Patients with polyarthritis may have symptoms that come and go very quickly, sometimes in < 24-36 hours. This migratory pattern characterizes diseases such as gonococcal arthritis, viral disease, and sarcoidosis. "Rheumatoid variants" such as Reiter's syndrome, psoriatic arthritis, and spondylitis may affect no more than a few joints and are accompanied by other signs, such as nail and skin lesions (psoriasis) or urogenital and enteric infections (Reiter's). Like erosive osteoarthritis, the rheumatoid variants may also cause swelling and inflammation of the distal interphalangeal joints. The classic example of symmetric joint disease is rheumatoid arthritis (RA). While RA often occurs in a progressive and additive pattern, its onset may be followed by a remission several months later. Patients who present with the "algias" may have no physical signs but manifest extensive musculoskeletal pain. Fibromyalgia occurs typically in younger women; polymyalgia rheumatica rarely occurs in patients < 50 years of age and is usually accompanied by a strikingly high ESR. Age and gender should be noted in the office evaluation because they can provide clues not only to these "algias," but other rheumatic diseases seen more frequently in one age or gender group than another.
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PMID:Office evaluation of the patient with musculoskeletal complaints. 921 53

The aim of the present retrospective and hospital-based study was to describe epidemiological and clinical features of rheumatic diseases in patients attending the University Hospital of Kinshasa (UHK). Rheumatic complaint was a reason for consultation in 12.1% of outpatients attending the Department of Internal Medicine of the UHK. Osteoarthritis was the most common rheumatic disease (59.2%), followed by soft tissue rheumatism (16.1%), gout (9.3%), and spondylarthropathies (7.5%). The cumulative frequency of autoimmune diseases (rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, dermatomyositis, and mixed connective tissues disease) and the frequency of osteoporosis were 5.2 and 2.7%, respectively. Lumbar spine was the part of the skeleton mostly affected by osteoarthritis. Pathological fractures in osteoporosis, subcutaneous nodules, rheumatoid factor, and erosive bone lesions in rheumatoid arthritis were rarely found. Compared to the previous studies performed in the same hospital, our results disclose a threefold increase of rheumatic outpatients. The paucity of erosive arthritis and extra-articular manifestations suggest the less severity of rheumatoid arthritis in our patients. Likewise, the absence of femoral and wrist osteoporotic fractures and the scarcity of advanced vertebral crush fractures suggest the mildness of osteoporosis.
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PMID:Clinical and epidemiological features of rheumatic diseases in patients attending the university hospital in Kinshasa. 1754 12

Copresent rheumatoid arthritis (RA) and gout is seldom reported. This study summarizes the findings of eight cases of copresent RA and gout and compares them with 31 pure RA cases. Additional reported cases were retrieved from the current literature by Medline search. Patients with copresent RA and gout were older (p = 0.014) and predominantly male (p < 0.01). Synovial fluid, positive for urate crystals, was aspirated most frequently from the knee (five out of eight), followed by the first metatarsophalangeal joint (three out of eight). Serum creatinine and urate levels in the copresent group were significantly higher (p < 0.01, both), and serum hemoglobin was lower (p = 0.04) than those with pure RA. Copresent subjects had much lower percentage of positive rheumatoid factor (RF) tests than patients with pure RA (37.5 vs 80.6%). Only one copresent subject had both RF and anti-cyclic citrullinated peptide antibody. Of copresent subjects, 75% had gouty arthritis before diagnosis of RA, which is consistent with earlier reports. Seven copresent subjects had gout attacks under disease-modifying antirheumatic drug use. This study revealed that polyarthritis negative for RF in a previously gouty patient may be RA and vice versa. This combination occurs more frequently in males. Moreover, anti-CCP antibody examination is not helpful for this diagnosis. Therefore, physicians must obtain synovial fluid for analysis in joints with intense swelling, especially in old RA subjects with renal insufficiency or involvement of lower extremities. Conversely, RA must be considered in gouty patients with polyarticular involvement.
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PMID:Rare copresent rheumatoid arthritis and gout: comparison with pure rheumatoid arthritis and a literature review. 1900 47

Avascular bone necrosis under immunosuppressive therapy is a well known sequel following solid organ transplantation. Most cases affect hip, knees or shoulders in more than one location and occur in connection with the use of high-dose steroids. In this 50 year old female immunosuppressive therapy consisted of sirolimus and mycophenolate mofetil after a renal transplantation 2 years ago. Steroids had been completely withdrawn after avascular necrosis of the femoral head. Physical examination revealed a reddened and painful left ankle. C-reactive protein was elevated while autoimmune antibodies, rheumatoid factor and screening for reactive arthritis remained negative. Joint fluid examination ruled out infection or gout. Plain radiographs were normal. Under the presumptive diagnosis of erysipelas antibiotic therapy was started, however, without success. Magnetic resonance imaging finally revealed bilateral tibial and tarsal bone necrosis as the underlying cause. In conclusion, avascular bone necrosis should remain an important differential diagnosis in patients with bone or joint pain and a history of organ transplantation, regardless of the present use of steroid therapy.
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PMID:[Avascular necrosis of the bone after organ transplantation]. 2033 75

A 58-year-old woman with a three-year progressive history of chronic arthritis, had become disabled due to general malaise and fever. Her laboratory data revealed hyperuricemia and elevated levels of C-reactive protein. Neither rheumatoid factor nor anti-citrullinated peptide antibodies were present. We diagnosed her with tophaceous gout with uric crystalline revealed by the arthrocentesis of the elbow. (99m)Tc scintigraphy also disclosed a significant uptake in the cervical spine. The CT of the patient's cervical spine revealed significant bone erosion and destruction. We diagnosed the cervical involvement of gout based on the exclusion of infections and sarcoidosis. Rheumatologists should be aware of this rare association.
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PMID:Tophaceous gout in the cervical spine. 2229 96


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