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CNSLF Med: Gout (Intro (tophaceous deposits (= chronic form, nodular…
CNSLF Med: Gout
Intro
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group of diseases resulting from deposition of monosodium urate crystals in tissues or extracellular fluids (supersaturation)
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tophaceous deposits
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nodular masses (complexes) of uric acid crystals (tophi) are deposited in different soft tissue areas of the body
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peak incidence @ 40-50 y/o in men, older in women
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US prevalence = 1.3% of men, 0.6% of women
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Acute gouty arthritis
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usually monoarticular, may be polyarticular
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also common @ ankle, DIPs (tophaceous enlargement + erythema, simulating OA)
Pathogenesis
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induce phagocytes + synovial cells to generate multiple inflamm enzymes, COX, lipoxygenases, proteases, TNF-alpha, IL1, IL6, bradykinin etc
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Prevention
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Allopurinol
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no effect on acute gout, so give with colchicine
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Tx
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colchicine inhibits microtubule polymerisation + prevents neutrophil mediated release of inflamm agents
effective if given early, not if inflamm cells have already migrated
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