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Review
. 2009 Aug;106(34-35):549-55.
doi: 10.3238/arztebl.2009.0549. Epub 2009 Aug 24.

Gout--current diagnosis and treatment

Anne-Kathrin Tausche  1 , Tim L Jansen, Hans-Egbert Schröder, Stefan R Bornstein, Martin Aringer, Ulf Müller-Ladner
Affiliations
Review

Gout--current diagnosis and treatment

Anne-Kathrin Tausche et al. Dtsch Arztebl Int. 2009 Aug.

Abstract

Background: Because of the changing dietary habits of an aging population, hyperuricemia is frequently found in combination with other metabolic disorders. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). In Germany, the prevalence of gouty arthritis is estimated at 1.4%, higher than that of rheumatoid arthritis. There are no German guidelines to date for the treatment of gout. Its current treatment is based largely on expert opinion.

Methods: Selective literature review on the diagnosis and treatment of gout.

Results and conclusions: Asymptomatic hyperuricemia is generally not an indication for pharmacological intervention to lower the uric acid level. When gout is clinically manifest, however, acute treatment of gouty arthritis should be followed by determination of the cause of hyperuricemia, and long-term treatment to lower the uric acid level is usually necessary. The goal of treatment is to diminish the body's stores of uric acid crystal deposits (the intrinsic uric acid pool) and thereby to prevent the inflammatory processes that they cause, which lead to structural alterations. In the long term, serum uric acid levels should be kept below 360 micromol/L (6 mg/dL). The available medications for this purpose are allopurinol and various uricosuric agents, e.g., benzbromarone. There is good evidence to support the treatment of gouty attacks by the timely, short-term use of non-steroidal anti-inflammatory drugs (NSAID), colchicine, and glucocorticosteroids.

Keywords: allopurinol; gout; hyperuricemia,deposits of uric acid; treatment.

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Figures

Figure 1
Figure 1
Acute gout attack with classic podagra and synovitis in the second metacarpophalangeal joint
Figure 2
Figure 2
Chronic gout. a) Tophaceous gout with destructive joint changes and subcutaneous deposits of uric acid, b) radiological changes in tophaceous gout
Figure 3
Figure 3
Treatment algorithm for gout *1 Dose titration of allopurinol depending on serum urate level, up to a maximum of 800 mg/d with monitoring of renal function; *2 urinary alkalization using citrate compounds to prevent urate stones (EL III); *3 not available in Austria and Switzerland; COX-2, cyclooxygenase-2; PPI, proton pump inhibitor; SUA, serum urate; Crea, creatinine; GFR, glomerular filtration rate; modified from (19)
See this image and copyright information in PMC

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References

    1. Mikuls TR, Farrar JT, Bilker WB, Fernandes S, Schumacher HR, Jr, Saag KG. Gout epidemiology: results from the UK General Practice Research Database, 1990-1999. Ann Rheum Dis. 2005;64:267–272. - PMC - PubMed
    1. Annemans L, Spaepen E, Gaskin M, et al. Gout in the UK and Germany: prevalence, comorbidities and management in general practice 2000-2005. Ann Rheum Dis. 2008;67:960–966. - PMC - PubMed
    1. Campion EW, Glynn RJ, DeLabry LO. Asymptomatic hyperuricemia. Risks and consequences in the normative aging study. Am J Med. 1987;82:421–426. - PubMed
    1. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and protein intake, and the risk of gout in men. N Engl J Med. 2004;350:1093–1103. - PubMed
    1. Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of incident gout in men: a prospective study. Lancet. 2004;363:1277–1281. - PubMed