Gout

Excerpt

Gout, once known as the "disease of kings and king of diseases," is among the most prevalent etiologies of chronic inflammatory arthritis in the United States, characterized by monosodium urate (MSU) monohydrate crystals deposition within tissues. Hippocrates first described gout in ancient Greece; hence, it is the most understood and manageable disease among all rheumatic diseases.

Gout is characterized biochemically by extracellular fluid urate saturation, which is reflected by hyperuricemia in the blood, with plasma or serum urate concentrations exceeding 6.8 mg/dL (approximately 400 µmol/L); this level is the approximate limit of urate solubility. The clinical manifestations of gout may include:

1. Acute gout flare (recurrent flares of inflammatory arthritis)

2. Chronic gouty arthropathy

3. Accumulation of urate crystals in the form of tophaceous deposits

4. Uric acid nephrolithiasis

5. Chronic nephropathy