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Guideline for gout management

Guideline for gout management

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Published by bestmonkey

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Published by: bestmonkey on Oct 03, 2009
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12/30/2012

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Guideline for goutmanagement
高雄長庚醫院風濕過敏免疫科高雄長庚醫院風濕過敏免疫科
(Arthritis)
 
 
Introduction
the deposition of monosodium urate( MSU ) crystals in the joints and softtissues.Incidence: 0.1%
 
 
Introduction
Crystal-Induced ArthritisCharacteristicGoutPseudogout
Prevalence1.5 to 2.6 cases per 1000 individuals;increases with age in men andpostmenopausal women; 15/1000 at age58; men:28/1000, women:11/1000<1 case per 1000 individuals; increaseswith ageCrystals
 
ChemistryMonosodium urateCalcium pyrophosphate dihydrate
 
AppearanceNegatively birefringent; needle-shapedWeakly positively birefringent; linear or rhomboidalArticular involvementMonoarticular > oligoarticular;polyarticular < 30%Monoarticular > oligoarticular Most frequently affected jointsFirst MTP joint
initially 50%
eventuall 90%Ankles, knees, other Knee, wrist other Predisposing conditions/risk factorsHyperuricemia*, obesity, hypertension,hyperlipidemia, alcohol ingestion, leadingeation, hereditary enzyme defect (rare)Hypothyroidism, hemochromatosis, OA,chronic renal insufficiency, diabetes,hyperparathyroidism, hereditary (rare)Therapeutic optionsAcute attacks:
NSAIDs, corticosteroids, colchicineChronic management
Urate-lowering agents, colchicineAcute attacks:
NSAIDs, corticosteroids, colchicineChronic management
NSAIDs
±
colchicine*Drugs associated with hyperuricemia include diuretios, low-dose salicylates, nicotinic acid, oyclosporine, ethanol andethambutol.

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