Gout usually appears in the lower extremities. It is caused by hyperuricemia and excess uric acid in the blood.
Gout, also known as gouty arthritis, is a disease known since Biblical times. According to specialists in rheumatology , is produced by the deposition in the joints of microcrystals of uric acid and affects those patients with hyperuricemia, ie excess uric acid in blood (one greater than 7 mg / dl concentration point solubility at body temperature uric acid).
It is noteworthy that uric acid is a product of purine degradation, a component present in the nuclei of cells. Any condition that produces a deficit in the renal excretion of uric acid or excess production can cause it to be deposited in the form of microcrystals in the joints. What causes this process is an inflammatory stimulus level of the articular synovial membrane, triggering arthritis.
Causes of gout
The cause of gout is hyperuricemia, although not all people who suffer from gout presented. There are two main causes for hyperuricemia occurs: the existence of a deficit in the elimination of uric acid in the kidney or excessive production. The most common cause (90% of cases) is the deficit elimination, and usually has a genetic component. However, certain factors may contribute to the onset of gout:
- purine diet (foods like red meat, seafood and meats)
- alcohol (decreases the elimination of uric acid)
- comorbidities that alter the endogenous metabolism (renal failure, psoriasis, blood dyscrasias involving changes in the number of white and red blood cells, etc.)
- some drugs
Symptoms and treatment of gout
Gout typically manifests with episodes of:
- intense joint pain (arthritis) with swelling
- increased local temperature
- increased sensitivity to touch
Moreover, usually it presented as a single arthritis (monoarthritis) in joints of the lower limbs (mainly the big toe or ankle).
Sometimes they can form accumulations of uric acid in the soft tissues, as ("tophi") hard nodules that sometimes can open and pour the contents out.
Today there are very effective treatments to reduce hyperuricemia which allow the dissolution of uric acid crystals, to avoid outbreaks of arthritis or deposits occur in soft tissues.
Who is affected by gout?
Gout usually affects adult patients. However, there are rare hereditary diseases included in the group of inborn errors of metabolism that can cause drop in childhood. One example is Lesch-Nyhan syndrome, caused by a deficiency of an enzyme (hypoxanthine guanine phosphoribosyltransferase), which regulates the metabolism of purines. This syndrome and a children's drop is associated with neurologic and cognitive dysfunctions.