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Gout
(RH004)

Introduction


Gout is a syndrome resulting from the deposition in and around joints of crystals composed of a substance called uric acid (monosodium urate crystals). Uric acid is the end product of the metabolism of a food component called purine. Increased levels of uric acid (hyperuricemia) is a result of either over-production or under-excretion of the substance.

Acute gout typically presents with pain, swelling, warmth and redness in a joint. Usually the first attack affects only one joint. Commonly affected is the large joint at the base of the big toe (podagra). Other joints commonly involved are the ankle, knee, instep or forefoot, wrist and fingers, elbows, and even the spine.

Acute attacks commonly start during the night and usually peak within one to two days of symptoms onset. Untreated attacks may last seven to 10 days.

Treatment goals include termination of the acute attack, prevention of recurrent attacks and prevention of complications (especially kidney disease) associated with the deposition of urate crystals in tissues. Treatment of associated features such as obesity, alcohol use, hypertension, and elevated cholesterol levels also figures prominently in the overall plan.

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