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1.
Article in Chinese | WPRIM | ID: wpr-921797

ABSTRACT

Chronical hyperuricemia, a severe metabolic disease characterized by increased serum uric acid, urea nitrogen, and creatinine, has a positive correlation with the risks of gouty arthritis, diabetes, hypertension, and kidney damage. Abnormal purine metabolism and reduced uric acid excretion are the major causes of hyperuricemia, which, thus, points to a potential strategy of preventing from or delaying the progress of hyperuricemia-related diseases and its complications by effectively controlling the serum uric acid level. Increasing evidence has revealed that Chinese medicines alleviate hyperuricemia through regulating intestinal flora, which plays a pivotal role in regulating metabolites, including uric acid level. The disease treatment with traditional Chinese medicine is based on syndrome differentiation, and Chinese medicines often have multiple effects and a wide range of targets. In this review, we summarized the anti-hyperuricemia effects and mechanisms of active compounds in Chinese medicines, single Chinese medicinal herbs, and Chinese medicinal prescriptions in regulating the uric acid level via intestinal flora and metabolites, which will be helpful for further study and application of Chinese medicines in hyperuricemia treatment.


Subject(s)
Arthritis, Gouty , China , Gastrointestinal Microbiome , Humans , Hyperuricemia/drug therapy , Uric Acid
2.
Article in Chinese | WPRIM | ID: wpr-879936

ABSTRACT

OBJECTIVE@#To detect the differentially expressed inflammatory proteins in acute gouty arthritis (AGA) with protein chip.@*METHODS@#The Raybiotech cytokine antibody chip was used to screen the proteomic expression in serum samples of 10 AGA patients and 10 healthy individuals. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis were applied to determine the biological function annotation of differentially expressed proteins and the enrichment of signal pathways. ELISA method was used to verify the differential protein expression in 60 AGA patients and 60 healthy subjects. The ROC curve was employed to evaluate the diagnostic value of differential proteins in AGA patients.@*RESULTS@#According to|log@*CONCLUSIONS@#Proteomics can be applied to identify the biomarkers of AGA, which may be used for risk prediction and diagnosis of AGA patients.


Subject(s)
Arthritis, Gouty/diagnosis , Cytokines/genetics , Gene Expression Profiling , Gene Expression Regulation , Humans , Inflammation , Protein Array Analysis , Proteomics
3.
Rev. cuba. reumatol ; 21(3): e105, sept.-dic. 2019. tab
Article in English | LILACS-Express | LILACS, CUMED | ID: biblio-1093831

ABSTRACT

Introduction: gouty arthritis is a persistent metabolic disease that produces an increase of the circulating uric acid, with the resulting deposit of monosodic urate crystals in the tissues. Objective: to characterize patients with gouty arthritis clinically and epidemiologically. Methods: a descriptive investigation of 72 patients with a diagnosis of gouty arthritis, assisted at Arnaldo Milián Castro Clinical Surgical University Hospital was carried out from January 2008 to December 2017. Results: patients between 40 and 49 years of age were the most representative group with a highest incidence in not white patients and the male sex. Obesity and hypertension prevailed as previous personal antecedents. Alcohol intake was the most represented toxic habit. A crisis of inflammation of the big toe was the more frequent starting manifestation. Swelling of soft tissues was the main radiologic alteration. Conclusion: gouty arthritis is present with a highest frequency in the male sex with a peak of incidence in the fourth decade of life. It is associated to bad diet habits and alcohol intake that could cause joint damage(AU)


Introducción: la artritis gotosa es una enfermedad metabólica persistente, que produce un aumento del ácido úrico circulante, con el consiguiente depósito de cristales de uratos monosódicos en los tejidos. Objetivo: caracterizar clínica y epidemiológicamente a los pacientes con artritis gotosa. Método: se realizó una investigación descriptiva de 72 pacientes con diagnóstico de artritis gotosa, atendidos en el Hospital Universitario Clínico Quirúrgico Arnaldo Milián Castro, entre enero del 2008 y diciembre del 2017. Resultados: los pacientes entre 40 y 49 años de edad fueron los más representativos, con mayor incidencia en no blancos y del sexo masculino. Predominó la obesidad y la hipertensión arterial como antecedentes patológicos personales. El alcohol fue el hábito tóxico mayoritariamente representado. La crisis de podagra resulto ser la manifestación inicial más usual. El aumento de partes blandas fue la principal alteración radiológica. Conclusiones: La gota se presenta con mayor frecuencia en el sexo masculino con un pico de incidencia en la cuarta década de la vida. Está asociada a malos hábitos dietéticos y al consumo de bebidas alcohólicas pudiendo ocasionar daño articular(AU)


Subject(s)
Humans , Alcohol Drinking/adverse effects , Arthritis, Gouty/epidemiology , Feeding Behavior/physiology , Metabolic Diseases
4.
Medisan ; 23(1)ene.-feb. 2019. graf
Article in Spanish | LILACS | ID: biblio-990183

ABSTRACT

Se presenta el caso clínico de un paciente de 57 años de edad, mestizo, con antecedentes de artritis reumatoidea y gota, quien acude a la consulta especializada de Dermatología del Hospital Clinicoquirúrgico Docente Celia Sánchez Manduley de Manzanillo, provincia de Granma, por presentar lesiones nodulares dolorosas diseminadas. Se realizaron estudios complementarios y biopsia de piel, cuyos resultados permitieron diagnosticar una gota tofácea crónica. El paciente llevaba tratamiento medicamentoso con prednisona, colchicina y metrotexate, pero luego de discutir el caso con los especialistas en medicina interna y reumatología se decidió sustituir la colchicina por el alopurinol.


The case report of a 57 year-old mestizo patient, is presented with a history of rheumatoid arthritis and gout who visited the specialized Dermatology department of Celia Sánchez Manduley Teaching Clinical-Surgical Hospital in Manzanillo, Granma province, for presenting disseminated painful nodular lesions. Complementary studies and skin biopsy were carried out which results allowed to diagnose a chronic . The patient was under drugs treatment with prednisona, colchicina and metrotexate, but after discussing the case with the specialists in internal medicine and rheumatology it was decided to sustitute colchicina by alopurinol.


Subject(s)
Humans , Male , Middle Aged , Arthritis, Gouty/diagnosis , Hyperuricemia , Gout , Uric Acid/metabolism , Secondary Care
5.
Article in English | WPRIM | ID: wpr-787190

ABSTRACT

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare but critical disease with a high mortality rate. The diagnostic dilemma of PPP syndrome is the fact that symptoms occur unexpectedly. A 48-year-old man presented with fever and painful swelling of the left foot that was initially mistaken for cellulitis and gouty arthritis. The diagnosis of PPP syndrome was made based on the abdominal CT findings and elevated pancreatic enzyme levels, lobular panniculitis with ghost cells on a skin biopsy, and polyarthritis on a bone scan. The pancreatitis and panniculitis disappeared spontaneously over time, but the polyarthritis followed its own course despite the use of anti-inflammatory agents. In addition to this case, 30 cases of PPP syndrome in the English literature were reviewed. Most of the patients had initial symptoms other than abdominal pain, leading to misdiagnosis. About one-third of them were finally diagnosed with a pancreatic tumor, of which pancreatic acinar cell carcinoma was the most dominant. They showed a mortality rate of 32.3%, associated mainly with the pancreatic malignancy. Therefore, PPP syndrome should be considered when cutaneous or osteoarticular manifestations occur in patients with pancreatitis. Active investigation and continued observations are needed for patients suspected of PPP syndrome.


Subject(s)
Abdominal Pain , Anti-Inflammatory Agents , Arthritis , Arthritis, Gouty , Biopsy , Carcinoma, Acinar Cell , Cellulitis , Diagnosis , Diagnostic Errors , Fever , Foot , Humans , Middle Aged , Mortality , Pancreatic Neoplasms , Pancreatitis , Panniculitis , Skin , Tomography, X-Ray Computed
6.
Article in English | WPRIM | ID: wpr-761542

ABSTRACT

Pancreatitis, panniculitis, and polyarthritis (PPP) syndrome is a rare but critical disease with a high mortality rate. The diagnostic dilemma of PPP syndrome is the fact that symptoms occur unexpectedly. A 48-year-old man presented with fever and painful swelling of the left foot that was initially mistaken for cellulitis and gouty arthritis. The diagnosis of PPP syndrome was made based on the abdominal CT findings and elevated pancreatic enzyme levels, lobular panniculitis with ghost cells on a skin biopsy, and polyarthritis on a bone scan. The pancreatitis and panniculitis disappeared spontaneously over time, but the polyarthritis followed its own course despite the use of anti-inflammatory agents. In addition to this case, 30 cases of PPP syndrome in the English literature were reviewed. Most of the patients had initial symptoms other than abdominal pain, leading to misdiagnosis. About one-third of them were finally diagnosed with a pancreatic tumor, of which pancreatic acinar cell carcinoma was the most dominant. They showed a mortality rate of 32.3%, associated mainly with the pancreatic malignancy. Therefore, PPP syndrome should be considered when cutaneous or osteoarticular manifestations occur in patients with pancreatitis. Active investigation and continued observations are needed for patients suspected of PPP syndrome.


Subject(s)
Abdominal Pain , Anti-Inflammatory Agents , Arthritis , Arthritis, Gouty , Biopsy , Carcinoma, Acinar Cell , Cellulitis , Diagnosis , Diagnostic Errors , Fever , Foot , Humans , Middle Aged , Mortality , Pancreatic Neoplasms , Pancreatitis , Panniculitis , Skin , Tomography, X-Ray Computed
7.
Article in English | WPRIM | ID: wpr-719451

ABSTRACT

BACKGROUND/AIMS: Gout is associated with metabolic disorders that are important risk factors for cardiovascular disease and erectile dysfunction (ED). We aimed to identify independent predictors of ED in patients with gout. METHODS: From August 2014 to August 2015, male outpatients who were being treated for gout in our rheumatology clinic and healthy males without any history of inflammatory disease (control group) were studied. ED was assessed in participants using the five-item version of the International Index of Erectile Function questionnaire. Insulin resistance (IR) was estimated using the homeostatic model assessment (HOMA-IR). Logistic regression analysis was performed to determine the effect of variables on ED risk in all of the study subjects and in patients with gout. RESULTS: We analyzed 80 patients with gout and 70 healthy controls. The median age of patients with gout was 52 years and median disease duration was 120 months. Gout patients were more likely to have ED than controls (55.3% vs. 41.4%, p < 0.047). After adjustment for confounding factors, only HOMA-IR was significantly associated with ED (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.05 to 3.15). Gout patients with ED were more likely to be older (p < 0.001), have higher HOMA-IR (p = 0.048), and have lower glomerular filtration rate (p = 0.038) than those without ED. Multivariate logistic regression analysis showed that HOMA-IR was an independent predictor for ED (OR, 1.62; 95% CI, 1.03 to 2.82) in gout patients. CONCLUSIONS: IR is an independent predictor of ED in patients with gout.


Subject(s)
Arthritis, Gouty , Cardiovascular Diseases , Erectile Dysfunction , Glomerular Filtration Rate , Gout , Humans , Insulin Resistance , Insulin , Logistic Models , Male , Outpatients , Rheumatology , Risk Factors
8.
Article in Chinese | WPRIM | ID: wpr-777466

ABSTRACT

The aim of this paper was to study the effect and mechanism of alcohol extract from Polygonum cuspidatum(PCE) on acute gouty arthritis in C57 BL/6 mice through NLRP3/ASC/caspase-1 axis. The model mice which injected with ankle joint injection of sodium urate crystals(MSU) were orally administrated with three different concentration of PCE, with colchicine as positive control. HE staining was used for observing the morphological changes of synovial tissue; concentration of IL-1β, IL-6 and TNF-α secreted by synovial tissue of the ankle joint were detected by ELISA; mRNA and protein expression of NLRP3, ASC and caspase-1 in synovial tissue were detected by RT-PCR and Western blot respectively. The results showed that the swelling degree of ankle joint in model mice were significantly elevated; expression of IL-1β, IL-6 and TNF-α were significantly increased; mRNA and protein expression of NLRP3, ASC and caspase-1 also significant increase, compared with normal control group. The swelling degree of ankle joint significantly relief; expression of IL-1β, IL-6 and TNF-α in joint synovium significantly decrease; mRNA and protein expression of NLRP3, ASC and caspase-1 were significantly decrease in PCE treatment group compared with model group. Our research implied that alcohol extract from P. cuspidatum had positive effect on acute gouty arthritis in mice, and the regulation of NLRP3/ASC/caspase-1 axis may be its mechanism.


Subject(s)
Animals , Ankle Joint , Arthritis, Gouty , Drug Therapy , CARD Signaling Adaptor Proteins , Metabolism , Caspase 1 , Metabolism , Fallopia japonica , Chemistry , Interleukin-1beta , Metabolism , Interleukin-6 , Metabolism , Mice , Mice, Inbred C57BL , NLR Family, Pyrin Domain-Containing 3 Protein , Metabolism , Plant Extracts , Pharmacology , Tumor Necrosis Factor-alpha , Metabolism , Uric Acid
9.
Article in Korean | WPRIM | ID: wpr-787470

ABSTRACT

BACKGROUND: Hyperuricemia refers to an excess of uric acid in the blood and is associated with gouty arthritis, hypertension, metabolic syndrome, atrial fibrillation, kidney stones, insulin resistance (IR), and type 2 diabetes mellitus. Previous studies have used the homeostatic model assessment of IR (HOMA-IR), a well-known index of IR, to investigation the correlation between serum uric acid levels and IR. However, difficulty with measuring insulin levels limits the clinical applicability of the HOMA-IR index. This study investigated the correlation between hyperuricemia and the triglyceride glucose (TyG) index.METHODS: We used data from the Seventh Korea National Health and Nutrition Examination Survey, 2016. The study population included adults without diabetes aged >19 years. The TyG index, which serves as an indicator of IR, was calculated using fasting serum glucose and triglyceride levels to investigate the correlation between the TyG index and hyperuricemia. Pearson's correlation coefficient and analysis of covariance were used for statistical analysis, which was performed using IBM SPSS software.RESULTS: A statistically significant correlation was observed between serum uric acid levels and the TyG index. After adjustment for factors that may affect IR (age, body mass index, waist circumference, and systolic and diastolic blood pressures), we observed that the TyG index was significantly higher in the hyperuricemia than in the non-hyperuricemia group (8.96 vs. 8.54, P < 0.001).CONCLUSION: Serum uric acid levels were significantly correlated with IR assessed using the TyG index in adults without diabetes aged >19 years.


Subject(s)
Adult , Arthritis, Gouty , Atrial Fibrillation , Blood Glucose , Body Mass Index , Diabetes Mellitus, Type 2 , Fasting , Glucose , Humans , Hypertension , Hyperuricemia , Insulin , Insulin Resistance , Kidney Calculi , Korea , Nutrition Surveys , Triglycerides , Uric Acid , Waist Circumference
10.
Immune Network ; : e21-2019.
Article in English | WPRIM | ID: wpr-764010

ABSTRACT

Calcium pyrophosphate (CPP) crystals can present as acute inflammatory arthritis which is known as an acute CPP crystal arthritis. Although monocytes/macrophages have been shown to play a role in the initiation of crystal-mediated inflammatory responses, differences in their phenotypes between acute CPP crystal arthritis and acute gouty arthritis have not yet been investigated. We examined the immunological characteristics of synovial monocytes/macrophages in patients with acute CPP crystal and acute gouty arthritis. CD14⁺CD3⁻CD19⁻CD56⁻ cell frequencies in synovial fluid mononuclear cells (SFMCs) were measured. Expression of pro- and anti-inflammatory cytokines and markers was determined. The SFMCs were dominated by a population of monocytes/macrophages in acute CPP crystal arthritis similar to that in acute gout. Synovial monocytes/macrophages showed the phenotypes of infiltrated monocytes as shown by expression of CD88, C-C chemokine receptor type 2, myeloid-related protein (MRP)8 and MRP14 but not proto-oncogene tyrosine-protein kinase MER. Comparatively, the CD14⁺ cells from patients with acute CPP crystal arthritis had similar high levels of IL-1β and TNF-α production but significantly lower expression of IL-10 and M2 marker (CD163). The monocytes/macrophages had the capacity to produce IL-8 in response to CPP crystals. Proinflammatory features were more dominant in monocytes/macrophages during acute CPP crystal arthritis than those during acute gouty arthritis.


Subject(s)
Arthritis , Arthritis, Gouty , Calcium Pyrophosphate , Calcium , Cytokines , Gout , Humans , Interleukin-10 , Interleukin-8 , Macrophages , Monocytes , Phenotype , Phosphotransferases , Proto-Oncogenes , Synovial Fluid
11.
Article in Korean | WPRIM | ID: wpr-717136

ABSTRACT

Gout occurs mainly in monoarthritis and is found in more than 50% of cases in hallux of the foot. In addition, symptoms sometimes begin in the hand, wrist, and elbow, but they are rarely observed in the spine. The patient was referred for tuberculous polyarthritis due to antituberculosis drug failure. Inflammatory findings were observed in the lumbar, elbow, wrist, hand and foot areas. Surgery was performed on the foot area and a pathology diagnosis revealed gouty arthritis. We report this case with a review of the relevant literature.


Subject(s)
Arthritis , Arthritis, Gouty , Diagnosis , Elbow , Foot , Gout , Hallux , Hand , Humans , Pathology , Spine , Wrist
12.
Article in French | AIM, AIM | ID: biblio-1259339

ABSTRACT

Les infections ostéo-articulaires (IOA) àStreptococcus pneumoniae sont rares chez les adultessains et elles surviennent, souvent, sur un terraind'immunodépression ou de pathologie articulaire.Nous rapportons ici un cas d'arthrite septiquesubaiguë de l'épaule à Streptococcus pneumoniaeobjectivée chez un sujet âgé, sain et chez qui on n'apas objectivé de pathologies sous jacentes qui enpourraient être responsable. Ainsi, le Streptococcuspneumoniae doit être évoqué devant toute infectionostéo articulaire, essentiellement chez les vieillards,même en l'absence des facteurs favorisantsclassiquement associés


Subject(s)
Aged , Arthritis, Gouty , Pneumococcal Infections , Shoulder , Tuberculosis, Osteoarticular
13.
Hip & Pelvis ; : 211-222, 2017.
Article in English | WPRIM | ID: wpr-10861

ABSTRACT

Arthritis damages the cartilage within joints, resulting in degenerative changes, including loss of function and joint instability. Ankylosing spondylitis (AS) is a chronic inflammatory condition affecting the spine and bone-to-tendon attachment area within the sacroiliac joint leading to back pain and progressive spinal stiffness. In the final stages, AS causes hyperkyphosis-a condition closely tied to the human leukocyte antigen-B27 gene. Rheumatoid arthritis is a chronic, systemic autoimmune disease characterized by the simultaneous inflammation of the synovium of multiple joints, leading to joint damage (e.g., destruction, deformation and disability). In the past, nonsteroidal anti-inflammatory drugs or conventional disease-modifying antirheumatic drug (DMARDs) have been used for the treatment of these autoimmune diseases, but biologic DMARDs have recently been introduced with excellent results. Gout is a chronic inflammatory disease that causes an alteration of joints resulting in severe pain. Specifically, gout is associated with an accumulation of uric acid within the body resulting from dysregulated purine metabolism, causing recurrent paroxysmal inflammation in the joints. Allopurinol and febuxostat are the primary treatment options for individuals with gout. It is necessary to have an accurate understanding of the pathogenesis, pathological ecology and treatment of AS, rheumatoid arthritis, and gouty arthritis, which are the representative diseases that may cause inflammatory arthritis.


Subject(s)
Allopurinol , Antirheumatic Agents , Arthritis , Arthritis, Gouty , Arthritis, Reactive , Arthritis, Rheumatoid , Autoimmune Diseases , Back Pain , Cartilage , Diagnosis , Ecology , Febuxostat , Gout , Humans , Inflammation , Joint Diseases , Joint Instability , Joints , Leukocytes , Metabolism , Sacroiliac Joint , Spine , Spondylitis, Ankylosing , Synovial Membrane , Uric Acid
14.
Article in English | WPRIM | ID: wpr-812080

ABSTRACT

Korean oriental medicine prescription is widely used for the treatment of gouty diseases. In the present study, we investigated anti-inflammatory effects of modified Korean herbal formulation, mixed extract of medicinal herbs (MEMH), and its modulatory effects on inflammatory mediators associated with gouty arthritis. Both in vitro and in vivo studies were carried out to assess the anti-inflammatory efficacy of MEMH on monosodium urate (MSU) crystals-induced gouty inflammation. MSU crystals stimulated human chondrosarcoma cell line, SW1353, and human primary chondrocytes were treated with MEMH in vitro. The expression levels of pro-inflammatory mediators and metalloproteases were analyzed. The effect of MEMH on NFκB signaling pathway in SW1353 cells was examined. Effect of MEMH on the mRNA expression level of pro-inflammatory mediators and chemotactic factor from human monocytic cell line, THP-1, was also analyzed. The probable role of MEMH in the differentiation process of osteoblast like cells, SaOS-2, after MSU treatment was also observed. To investigate the effects of MEMH in vivo, MSU crystals-induced ankle arthritic model was established. Histopathological changes in affected joints and plasma levels of pro-inflammatory mediators (IL-1β and TNFα) were recorded. MEMH inhibited NFκB signaling pathway and COX-2 protein expression in chondrocytes. MSU-induced mRNA expressions of pro-inflammatory mediators and chemotactic cytokines were suppressed by MEMH. In MSU crystals-induced ankle arthritic mouse model, administration of MEMH relieved inflammatory symptoms and decreased the plasma levels of IL-1β and TNFα. The results indicated that MEMH can effectively inhibit the expression of inflammatory mediators in gouty arthritis, demonstrating its potential for treating gouty arthritis.


Subject(s)
Anti-Inflammatory Agents , Arthritis, Gouty , Drug Therapy , Genetics , Allergy and Immunology , Cell Line , Chondrocytes , Allergy and Immunology , Drugs, Chinese Herbal , Humans , Interleukin-1beta , Genetics , Allergy and Immunology , NF-kappa B , Genetics , Allergy and Immunology , Plants, Medicinal , Chemistry , Tumor Necrosis Factor-alpha , Genetics , Allergy and Immunology , Uric Acid
15.
Pakistan Journal of Pharmaceutical Sciences. 2017; 30 (6): 2101-2108
in English | IMEMR | ID: emr-189720

ABSTRACT

Monosodium urate monohydrate crystals are deposited in peripheral joints causing gout and elicit an intense localized inflammatory attack whereas in collecting ducts and medullary interstitium as a urinary calculi which causes dysuria, nausea and hematuria. The purpose of present study is to observe possible growth patterns of monosodium urate monohydrate crystals. The crystals were grown in test tubes by single diffusion gel technique and were observed at 7[th], 14[th], 21[st], 28[th] and 40[th] day. Needle and spherulite type crystals were observed at 14[th] day, while arboresque, crystal sheaves, densely branched, dumbbell, mushroom type spherulites, plumose and hexagonal prismatic crystals were observed for the first time. After 40[th] day complete spherulites were observed with their aggregates. The crystals were characterized by Scanning Electron Microscopy, Energy-Dispersive X-ray and Fourier Transform Infra Red spectroscopies. The pattern of MSUM will be helpful to determine the role of different natural products in the modulation, inhibition or promotion of these crystals by affecting the shape, size, transparency, approximate number and total mass of growing crystals. In case of inhibition or modulation it will be helpful for evaluation the prophylactic management whereas the promotion of the crystal will give an idea about the risk factors of gout and kidney stones


Subject(s)
In Vitro Techniques , Immunodiffusion , Arthritis, Gouty , Urolithiasis , Gels
16.
Korean Journal of Spine ; : 50-52, 2017.
Article in English | WPRIM | ID: wpr-84691

ABSTRACT

Gout is an inflammatory arthritis characterized by deposition of monosodium urate crystals in joints. Though gout frequently involves the big toe or other extremities, it rarely occurs in the spinal canal. A 35-year-old man presented with left L5 radiculopathy. He had leg pain for 8 months and received several epidural steroid injections. Magnetic resonance imaging revealed a 1.7×1.1-cm ovoid contrast-enhancing mass, causing pressure erosion of the left L5 pedicle. Microscopic laminotomy was performed at the left L5 lamina. White chalky materials, identified at the left lateral recess of the spinal canal, were removed in a piecemeal manner. The histopathologic diagnosis was tophaceous gout. Although the patient's radiating pain did not resolve postoperatively, it was dramatically relieved with uric acid-lowering medications. If a mass effect is suspected, surgical removal of gouty tophi might aid in symptom release and definite diagnosis. Medical treatment after rheumatology consultation is crucial.


Subject(s)
Adult , Arthritis , Arthritis, Gouty , Diagnosis , Extremities , Gout , Hallux , Humans , Hyperuricemia , Joints , Laminectomy , Leg , Magnetic Resonance Imaging , Radiculopathy , Rheumatology , Spinal Canal , Uric Acid , Zygapophyseal Joint
18.
Article in Chinese | WPRIM | ID: wpr-304305

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the effects of arthroscopic debridement for acute gouty arthritis of the ankle.</p><p><b>METHODS</b>Forty-one patients with acute gouty arthritis of the ankle were treated under arthroscopy from January 2010 to June 2012. All the patients were male, age in ranging from 28 to 69 years with an average of 43 years. Eighteen patients were in the left ankles and 23 in the right ankles; 12 cases were firstly attack and 29 cases were recurrent attack. Course of disease was from 2 weeks to 30 months. The American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score was used to evaluate the clinical effects. Number of acute attacks of gouty arthritis were observed.</p><p><b>RESULTS</b>All the patients were followed up at least 12 months. The mean AOFAS Ankle-Hindfoot Scale score increased from 58.44 +/- 9.45 preoperatively to 86.15 +/- 7.36, 83.41 +/- 9.22, 84.10 +/- 8.22 postoperatively at 6, 12, months and the last follow-up respectively. Swelling of the ankle were improved significantly, pain was relieved and the mean number of acute attacks of gouty arthritis decreased significantly.</p><p><b>CONCLUSION</b>Arthroscopy is helpful for the diagnosis of acute gouty arthritis of the ankle and improvement of clinical symptoms and ankle function.</p>


Subject(s)
Adult , Aged , Ankle Joint , General Surgery , Arthritis, Gouty , General Surgery , Arthroscopy , Debridement , Female , Humans , Male , Middle Aged , Treatment Outcome
19.
Yonsei Medical Journal ; : 1139-1144, 2016.
Article in English | WPRIM | ID: wpr-34051

ABSTRACT

PURPOSE: Patients with gout are similar to those with bacterial infection in terms of the nature of inflammation. Herein we compared the differences in procalcitonin (PCT) levels between these two inflammatory conditions and evaluated the ability of serum PCT to function as a clinical marker for differential diagnosis between acute gouty attack and bacterial infection. MATERIALS AND METHODS: Serum samples were obtained from 67 patients with acute gouty arthritis and 90 age-matched patients with bacterial infection. Serum PCT levels were measured with an enzyme-linked fluorescent assay. RESULTS: Serum PCT levels in patients with acute gouty arthritis were significantly lower than those in patients with bacterial infection (0.096±0.105 ng/mL vs. 4.94±13.763 ng/mL, p=0.001). However, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels showed no significant differences between the two groups. To assess the ability of PCT to discriminate between acute gouty arthritis and bacterial infection, the areas under the curves (AUCs) of serum PCT, uric acid, and CRP were 0.857 [95% confidence interval (CI), 0.798-0.917, p<0.001], 0.808 (95% CI, 0.738-0.878, p<0.001), and 0.638 (95% CI, 0.544-0.731, p=0.005), respectively. There were no significant differences in ESR and white blood cell counts between these two conditions. With a cut-off value of 0.095 ng/mL, the sums of sensitivity and specificity of PCT were the highest (81.0% and 80.6%, respectively). CONCLUSION: Serum PCT levels were significantly lower in patients with acute gouty attack than in patients with bacterial infection. Thus, serum PCT can be used as a useful serologic marker to differentiate between acute gouty arthritis and bacterial infections.


Subject(s)
Area Under Curve , Arthritis, Gouty/diagnosis , Bacterial Infections/diagnosis , Biomarkers/blood , Blood Sedimentation , C-Reactive Protein/metabolism , Calcitonin/blood , Case-Control Studies , Cross-Sectional Studies , Diagnosis, Differential , Female , Humans , Inflammation , Leukocyte Count , Male , Middle Aged , Protein Precursors/blood , Sensitivity and Specificity , Uric Acid/blood
20.
Article in Korean | WPRIM | ID: wpr-45955

ABSTRACT

No abstract available.


Subject(s)
Arthritis, Gouty , Diagnostic Imaging
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