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)

The sparing effect of hemiplegia on the development of tophaceous gout is described. The useless upper limb had no tophaceous deposits and the partially paralysed lower limb had only limited urate deposits. Disuse was presumably the major contributor to the limited deposition of urates on the paralysed side.
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PMID:Sparing effect of hemiplegia on tophaceous gout. 100 22

The authors report on 14 cases of osteonecrosis of the femoral head (ONFH) in patients suffering from gout. The cases of association were discovered over a period of 10 years among 232 patients with ONFH and 651 with gout. The necrosis had no particular characteristics except that there was a clear preponderence in males and a slight tendency to be bilateral; it occurred, perhaps, at a slightly earlier age. The patients with gout did not show any special clinical features ; the gout always preceded the necrosis, on average by 7 1/2 years. There was no obvious history of painful crises in the hip that could be attributed to the acute gout, except in one case. The excess of urate was detected by the baseline level of uricaemia (91 mg/litre on average), by the frequency of tophus (4 out of 14), and by the frequency of urinary lithiasis (2 out of 14), and did not appear to be any greater in the patients with gout and ONFH than it was in the whole of the population of gout patients. In those patients in whom it was estimated, the lipid analysis showed most frequently an increase in total lipids, in triglyceridaemia, and in cholesterolaemia. In the 5 patients in whom the investigations were sufficiently detailed, the dyslipidaemia was of Frederickson type II + IV (mixed hyperlipidaemia according to de Gennes' classification). Different physiopathological hypotheses are discussed by the authors, notably those concerned with micro-particulate fatty emboli (lipomicrons), which may obstruct, among others, the terminal arteries of the femoral head. Of the 6 patients for whom it was possible to obtain information, for an average period of 10 years since the onset of the necrosis, 2 had presented with untreated hyperlipidaemia and a severe general vascular illness (myocardial infarction in one case and regressive hemiplegia in the other). These findings lead to the conclusion that correction of the hyperlipidaemia by diet is indispensable to ensure the long-term survival of these patients.
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PMID:[Gout, hyperuricemia and femur head osteonecrosis (FHON)]. 117 24

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

An 85 year old man with a longstanding history of non-tophaceous gout developed a single large tophus, unassociated with inflammation, on his paretic leg over a six week period following an acute hemiplegia. The rapidity of tophus formation, its localisation to the paretic limb, and the apparent blunting of the acute inflammatory response represent a previously unreported interaction between gout and neurological deficit.
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PMID:Rapid development of a tophus following ipsilateral hemiparesis. 848

We report a 66-year-old Chinese man with chronic renal insufficiency (creatinine 1.7 mg/dL) and gout suffering from slurred speech and right hemiplegia for 3 days. Acute cerebral infarction was confirmed by computed tomography. Conscious disturbance occurred on the tenth hospital day without significant changes on imaging study when compared with a previous scan. Hypercalcemia (total calcium 14.1 mg/dL) and acute exacerbation of chronic renal failure (serum creatinine 2.5 mg/dL) were noticed. Hypercalciuria (FECa 3.2%), and low serum levels of intact parathyroid hormone and 1,25(OH)2D3 suggested nonparathyroidal hypercalcemia. An extensive workup failed to identify any etiology of hypercalcemia. Hypercalcemia and renal failure were temporarily ameliorated after aggressive volume expansion and loop diuretic treatment but recurred 2 weeks later. Immobilization hypercalcemia was considered after the exclusion of other discernible causes and was successfully treated with rehabilitative exercises and bisphosphonates without further recurrence during a 2-year follow-up. Clinical alertness to immobilization as a possible cause of hypercalcemia may avoid unnecessary and invasive examinations, life-threatening complications and annoying recurrences.
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PMID:An unrecognized cause of recurrent hypercalcemia: immobilization. 1663 46

We describe a systemic sclerosis and cerebral vascular accident case in which the cutaneous manifestation and the distal acroosteolysis occurred in an asymmetrical way in the non-paretic limb. The subsequent sclerodermic alterations and the acroosteolysis acquired an asymmetric pattern, sparing the patient's hemiparetic side. Although a number of definitions of this protective effect may be found in other rheumatic diseases, such as rheumatoid arthritis and gout, we found in the literature only one previous case describing the protective effect of the hemiplegia in scleroderma.
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PMID:Asymmetric scleroderma in a CVA patient. 1847 12

The main obstacle to the treatment of hyperuricemia in patients with allergy to allopurinol is the limited availability of equally efficient alternative drugs. The authors present a clinical case of a patient with incapacitant tophaceus gout, allergy to allopurinol and contraindication for uricosurics, who was treated with rasburicase, an urato-oxidase recombinant, based on experience with this drug in tumoral lisis and in some cases reports of tophaceus gout. The authors also enhance the fact of being a patient with a sequelar hemiplegia of a previous cerebrovascular disease that presents tophus only in the not paretic member. The management of patients with allergy to allopurinol can be a clinical challenge, and the monthly rasburicase perfusions may be an alternative treatment of serious gout not treatable for other ways.
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PMID:[Rasburicase for tophaceus gout treatment]. 1982 Jun 80