Gout

 by Alan Matsumoto, M.D.

Perhaps the oldest known type of arthritis, gout or gouty arthritis has been described since Hippocrates in the 5^th century B.C. At one time, the term "gout" was used to describe all types of arthritis. Known as the "Disease of Kings" due to its association with rich foods and alcohol consumption, COLORful depictions of gout can be found in art and literature often with commentary on the moral character of the gout sufferer.

"The Gout" by James Gilray, 1799. Gout depicted as an evil demon attacking a toe.

"By Royal Authority" by George Cruickshank. A gout sufferer helped onto his horse.

The association of gout and uric acid has been known since the 19^th century, but it is our understanding of the biochemistry of uric acid production by the body in the 1960's that has led to effective therapy for gout. Today, gout remains one of the most treatable forms of arthritis.

Next:: Clinical Presentation of Gout

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References

1. Campion EW, Glynn RJ, deLabry LO. Asymptomatic Hyperuricemia Risks and Consequences. Am J Med 82:421, 1987.

2. Groft GD, Franck WA, Raddarz DA. Systemic Steroid Therapy for Acute Gout: A clinical trial and review of the literature. Semin Arthritis Rheum 19:329, 1990.

3. Roberts WN, Liang MH, Stein SH. Colchicine in Acute Gout Reassessment of Risks and Benefits. JAMA 257:1920, 1987.

4. Wallace SL, Singer JZ. Review: Systemic Toxicity Associated with Intravenous Administration of Colchicine--Guidelines for Use. J Rheumatol 15ž495, 1988.

5. Gutman AB. Gout. Textbook of Medicine. 12^th ed., Beeson PB and McDermott W (eds), Philadelphia: W. B. Saunders, 1958, p 595.

6. Paulus HE, Schlosstein LH, godfrey RL, et al. Prophylactic Colchicine Therapy of Intercritical Gout. A placebo-controlled study of probenecid-treated patients. Arthritis Rheum 17:609, 1987.

7. Kelly WN, Wortmann RL. Gout and Hyperuricemia. Textbook of Rheumatology. 5^th ed., Kelly WN, Harris ED Jr., Ruddy S, Sledge CB (eds), Philadelphia: W. B. Saunders, 1997, p 1313-1347.

8. Emmerson BT. The Management of Gout. N Engl J Med 344:445, 1996.

9. Halz-LeBlanc BAE, Reynolds WJ, MacFadden DK. Allopurinol Hypersensitivity in a Patient with Chronic Tophaceous Gout: Success of intravenous desensitization after failure of oral desensitization. Arthritis Rheum 34:1329, 1991.

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