Gout

Abstract

The term ‘gout’ means inflammation of a joint, or arthritis, due to crystals of uric acid (monosodium urate monohydrate). Etymologically, it probably derives from gutta, meaning ‘a drop’ in Latin. This is thought to reflect a belief that the symptoms resulted in drops of toxins into the joint.

Keywords: urate; uric acid; hyperuricaemia; tophus; tophi; xanthine oxidase; purine; oxipurine; allopurinol; uricosuric; probenecid; crystal arthritis; benzobromarone; colchicine; hypoxanthine‐guanine‐phosphoribosyl‐transferase; allantoin; uricase

Figure 1.

Urate crystal, phagocytosed by polymorphonuclear leucocyte.

Figure 2.

Chronic gouty arthritis of the hands.

Figure 3.

Tophus on ear.

Figure 4.

Diagram showing the metabolic breakdown of nucleic acids to purines, pyrimidines and uric acid. Uric acid is not a normal dietary constituent; the body pool is derived from dietary purines and the breakdown of endogenous nucleic acids. PRPP, phosphoribosylpyrophosphate; HGPRTase, hypoxanthine–guanine phosphoribosyltransferase.

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Further Reading

Dessein PH, Shipton EA, Stanwix AE, et al. (2000) Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Annals of the Rheumatic Diseases 59: 539–543.

Facchini F, Chen Y‐D, Hollenbeck CB and Reaven GM (1991) Relationship between resistance to insulin‐mediated glucose uptake, urinary uric acid clearance and plasma uric acid concentration. Journal of the American Medical Association 266: 3008–3011.

Fam AG (2001) Difficult gout and new approaches for control of hyperuricaemia in the allopurinol‐allergic patient. Current Rheumatology Reports 3: 29–35.

Fam AG (2002) Gout, diet, and the insulin resistance syndrome G. Journal of Rheumatology 29: 1350–1356.

Grahame R, Simmonds HA and Carrey EA (2003) Gout at your Fingertips. London: Class Publishing.

Hall AP, Barry PE, Dawber TR and McNamara PM (1967) Epidemiology of gout and hyperuricaemia. American Journal of Medicine 42: 27–37.

Johnson RJ and Tuttle KR (2001) Much ado about nothing, or much to do about something? The continuing controversy over the role of uric acid in cardiovascular disease. Hypertension 35: 10.

Klippel JH and Dieppe PA (eds) (1998) Rheumatology, 2nd edn, vol. 2, sect. 8. London: Mosby.

Lesch M and Nyhan WL (1964) A familial disorder of urate metabolism and central nervous system function. American Journal of Medicine 36: 561–570.

Porter R and Rousseau GS (1998) Gout: The Patrician Malady. New Haven: Yale University Press.

Simkin PA (1977) The pathogenesis of podagra. Annals of Internal Medicine 86: 230–233.

Wyngaarden JB (1974) Metabolic defects of primary hyperuricaemia and gout. American Journal of Medicine 56: 651–664.

Wyngaarden JB and Kelley WN (1976) Gout and Hyperuricaemia. New York: Grune & Stratton.

Yu T‐F (1974) Milestones in the treatment of gout. American Journal of Medicine 56: 676–685.

http://amedec.amg.gda.pl/∼essppmm/ [This is the website of the European Society for the Study of Purine and Pyrimidine Metabolism in Man (ESSPPMM). It includes information on metabolic disorders and on diagnostic services in the EU.]

http://www.pumpa.co.uk [The website of the Purine Metabolic Patients Association, aimed at those with or relatives with the rarer metabolic disorders.]

http://www.ukgoutsociety.org/ [New information source, launched 2002.]

http://www.ssiem.org.uk/ [The website of the Society for the Study of Inborn Errors of Metabolism.]

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How to Cite close
Snaith, Michael L(Jul 2003) Gout. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0002311]