Quality of Care in Gout
Key Points • Surprisingly, instances of suboptimal treatment of gout remain frequent, even in this era of expanded and well-understood treatment options. These include errors in medication use and dosages…
Diet, Alcohol, Obesity, Hyperuricemia, and Risk of Gout
Key Points • Lifestyle and dietary modifications can influence serum urate levels and the risk of gout and are the only acceptable options when urate-lowering medications are not yet indicated…
Uricosuric Therapy of Hyperuricemia in Gout
Key Points • Inefficient renal excretion of uric acid is the most common cause of hyperuricemia in gout patients. • Uricosuric drugs tend to normalize renal excretion of uric acid…
Clinical Features of Gout
Key Points • The key clinical features of acute gouty arthritis have been recognized for hundreds of years and include podagra (inflammatory arthritis of the first metatarsophalangeal joint), rapid rise…
Gout: Epidemiology and Risk Factors
Key Points • Unlike osteoarthritis and rheumatoid arthritis, gout is typically an episodic arthritis. The intervals between attacks can be as long as decades with complete absence of symptoms between…
Articular Pathology of Gout, Calcium Pyrophosphate Dihydrate and Basic Calcium Phosphate Crystal Deposition Arthropathies
Key Points • Each crystal type associated with arthritis forms in specific joint tissues dependent on the distinct metabolic environment. • Crystals require additional factors beyond tissue deposition to incite…
Renal Basis of Hyperuricemia
Key Points • Approximately 90% of cases of hyperuricemia are caused by uric acid underexcretion from the kidneys. In addition, renal hypouricemia is caused by increased renal uric acid excretion….
Purine Metabolism in the Pathogenesis of Hyperuricemia and Inborn Errors of Purine Metabolism Associated With Disease
Key Points • Purine nucleotide synthesis and degradation form a crucial metabolic pathway for cell integrity and reproduction. • Phosphoribosyl pyrophosphate synthetase superactivity, a rare X chromosome–linked disorder, causes juvenile…
Genetics of Gout
Key Points • Serum urate levels are highly heritable and principally determined by the fractional excretion of uric acid in the kidney. The heritability of gout remains to be properly…
Treatment of Acute Gout
Key Points • Nonsteroidal antiinflammatory drugs (NSAIDs) (or cyclooxygenase-2–selective coxibs), systemic oral corticosteroids (prednisone or prednisolone), and colchicine are the primary therapy options for an acute gout attack. However, there…
