Gout – “disease of kings”
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Klinika Chorób Wewnętrznych i Reumatologii CSK MON WIM w Warszawie; kierownik: prof. dr hab. n. med. Witold Tłustochowicz
Publication date: 2017-10-02
LW 2017;95(4):383–388
Gout is a disease caused by accumulation of excess monosodium urate crystals in joint fluid, tissues and organs. This process is a result of long‑standing hyperuricemia, defined as an abnormally high level of uric acid in the serum >6 or 7 mg/dl. Gout is one of the most common forms of inflammatory arthritis. It affects about 1 to 2% of adults of the western population. If untreated, it results in disability and poorer life quality. Confirming the presence of typical monosodium urate crystals in the joint fluid or tophus under polarized light microscopy, has been the gold standard for the diagnosis of gout. In patients with normal kidney function, allopurinol is still recommended for first‑line urate‑lowering therapy (ULT). In case of intolerance or presence of contraindications to allopurinol, a newer xanthine oxidase inhibitor – febuxostat, is recommended. In contrast to allopurinol it does not require reduction of dose in patients with moderate kidney failure. The article presents a 64‑year‑old man hospitalized in the Department of Internal Diseases and Rheumatology due to recurrent pain and swelling of peripheral joints.