Gout: Causing Factors and Counter Strategies
AbstractGout is an inflammatory arthritis caused by hyper-uri-cemia in blood. It mostly occurs in the middle or later part of the life, so considered as the arthritis of elders with increasing frequency in current years about 1 - 2% of the Western part of the world. Generally, it is cha-racterized by repeated attacks of acute inflammatory arthritis (a red, tender, hot, swollen joint) and first cli-nical manifestation of gout is inflammation of (big toe) 1stmetatarso-phalangeal joint. It may present with sub-cutaneous or intra articulate tophi, kidney stones or urate nephropathy caused by increased levels of serum uric acid which crystallize and are deposited in joints kidneys and other soft tissues. Uric acid is a by - pro-duct of purine metabolism, being broken down by the action of xanthine oxidize enzyme into soluble allan-toin easily excreted through kidneys. Hyper-uricemia may be due to over production of uric acid or may be due to under - secretion of uric acid resulting in gouty arthritis. Diagnosis mostly established by lab tests, high resolution ultra-sonography, MRI, CT scans of joint, kidneys and other soft tissues for hyper-urice-mia, and for the visualization of the uric acid crystals / stones. Treatment strategies may includes non-steroidal anti-inflammatory drugs (NSAIDs), steroids, col-chicines, changes in life style and dietary habits impro-ve the symptoms of inflammation. After an acute atta-ck of gout the levels of uric acid can be lowered by modification in lifestyle in the form of appropriate exercise therapy and by taking DASH diet. In those with frequent attacks allopurinol or febuxostat provi-des prevention in long run. Advanced therapies have been attempted such as Egloticase as well role of vita-min C is very important in the prevention and treat-ment of gout.
Key Terms: Hyper-uricemia, Monosodium urate cry-stals, Uricase, DASH diet, Exercise.
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