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Article / Health / Diseases and Conditions | Post Comments |
Epiglottitis |
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By : Dr. Sunitha , NJ, USA 21.3.2011 Phone:- Fax:- Mail Now | |
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Gout is a disease which involves small joints and presents as pain and swelling. Gout results from overload of uric acid crystals which are formed and deposited in different tissues of joints. This leads to inflammation and Gouty Attacks. This is a recurrent and progressive process, which leads to joint destruction. Gout can also affect kidney functions because of the formation of uric acid stones in kidneys also called Nephrolithiasis. Causes : Gout is caused by inherent abnormality of the body to process uric acid. Uric Acid is a product of protein break down. Uric Acid Crystals are formed and deposited in and around joints - joint linings or syanovial membranes and joint fluids. This causes inflammation and severe pain and swelling of joints. As Gout progresses attacks occur more frequently leading to joint destruction. There are many risk factors/ causes such as :- §
Obesity
- Excessive weight gain
§
Moderate
to heavy Alcohol (Alcohol
causes diuresis leading to dehydration, Alcohol
also causes hyperuricemia (abnormally high level of uric acid in the blood)) §
High
Blood Pressure §
Kidney
Dysfunction
§
Chronic intake of medications
such as Thyazide, low dose Aspirin, Niacin, Cyclosporin
§
Diseases
such as Leukemia, Lymphoma, Hemoglobin disorders §
Hypothyroidism Conditions precipitating attacks are dehydration, Fever,
Excessive Sweating, Alcohol, and recent surgery. Signs and Symptoms
: Pain and Swelling of small joints especially big toe are the
main symptoms. Redness and Warmth,
excessive tenderness and fever may be present. Attacks subside in hours to-days
with or without treatment. Bursitis (Inflammation of joint coverings) may be
seen.
Small nodular masses or Uric Acids crystals or Trophi may be
deposited anywhere in the body including vocal cords and spine. Diagnosis: History – Sudden onset of pain Physical Examination – Joint Swelling and tenderness Blood Test – To check increased Uric acid levels acid levels X ray – Bone damage may be present
Aspiration of Joint fluid – Aspirate may show Uric Acid Crystals under
Polarizing microscope. Treatment: Goals of Treatment are to stop the acute attack and prevent further attacks. Elevation of the affected extremity (part) and hydration helps during the attacks.
Ø Drugs to increase kidney excretion of Uric acids are Probenezid and sulfinpyrzone. Ø Drugs to decrease the production of Uric Acid such a Allopurinol and Febuxostat. Intravenous
medications such as Krystexxa is used in resistant cases. Prevention : Dietary changes may help to reduce the frequency of attacks. Uric Acid is a product of Purine metabolism, so avoiding purine rich foods may help. Organ meats such as kidney, brain and seafood's are rich in purine. Avoiding Alcohol especially Beer and liquor is necessary. Fructose from soft drinks increases the frequency of attacks. Diary products may decrease the attacks. Weight reduction decreases the attacks. Vitamin C and Dietary Calcium may reduce the frequency of attacks. |