Gout is a disease caused by the accumulation of urate crystals, a salt derived from uric acid, in joints, soft tissues and kidneys. It is more common in middle-aged men, the elderly or women after menopause.
The cause is an elevation of uric acid levels in the blood (hyperuricemia); due to an increase in its production and/or a decrease in its renal elimination. Unhealthy lifestyles, obesity, excessive alcohol intake and foods rich in purines (red meat, offal, oily fish, shellfish) act as triggers; there is also a genetic predisposition.
The first symptom is usually acute inflammation of a joint (arthritis). The joint pain is intense, has an abrupt onset and lasts for days. Fifty percent of cases involve the big toe (podagra). There may be long periods without symptoms between each episode.
Diagnosis is clinical by questioning, physical examination and joint fluid analysis.
Pain should be treated with anti-inflammatory and analgesic drugs (colchicine and/or indomethacin) in the acute phase. Measures to lower uric acid and prevent recurrences should be initiated.
- Michael A Becker, MD.Clinical manifestations and diagnosis of gout. UpToDate, Septiembre, 2016.
- Michael A Becker, MD. Treatment of acute gout. UpToDate, Marzo, 2016.
- Neogi T. Clinical practice. Gout. N Engl J Med 2011; 364:443.
- Becker MA. We can make gout management more successful now. Curr Opin Rheumatol 2008; 20:167.
- H. Ralph Schumacher. Gota y otras artropatías por cristales. Harrison. Principios de Medicina Interna, 19e. Capítulo 395.
