单词 | rich man's disease |
释义 | SymptomsMost hyperuricemic people are asymptomatic between acute attacks. When an attack of acute gouty arthritis develops, it usually begins at night with moderate pain that increases in intensity to the point where no body position provides relief. Low-grade fever and joint inflammation (hot, exquisitely tender, dusky-red or cyanotic joints) may be present. See: illustration TreatmentColchicine, nonsteroidal anti-inflammatory agents, or corticosteroids are used to treat acute gouty attacks. Long-term therapy aims at preventing hyperuricemia by giving uricosuric drugs such as probenecid, or xanthine oxidase inhibitors such as allopurinol. Patients with gout have a tendency to form uric acid kidney stones. The diet should be well balanced and devoid of purine-rich foods, e.g., anchovies, sardines, liver, kidneys, sweetbreads, lentils, beer, wine, and other alcoholic beverages, because these raise urate levels. Fluid intake should be encouraged. Patient careDuring the acute phase, bedrest is prescribed for at least the first 24 hr, and affected joints are elevated, immobilized, and protected by a bed cradle. Analgesics are administered, and hot or cold packs applied, depending on which the patient finds most helpful. The patient is taught about these measures. Colchicine, nonsteroidal anti-inflammatory agents, prednisone, or other prescribed drugs are administered. Allopurinol may be prescribed as maintenance therapy after acute attacks to suppress uric acid formation and control uric acid levels, thus preventing future attacks. Patients should be warned to report adverse effects of allopurinol, e.g., drowsiness, dizziness, nausea, vomiting, urinary frequency, dermatitis. A low-purine diet is recommended. The importance of gradual weight reduction is explained if obesity, which places additional stress on painful joints, is a factor. If soft-tissue tophi are present, e.g., near joints in fingers, knees, or feet, the patient should wear soft clothing to cover these areas and should use meticulous skin care and sterile dressings to prevent infection of open lesions. Surgery may be required to excise or drain infected or ulcerated tophi, to correct joint deformities, or to improve joint function. Even minor surgery may precipitate gouty attacks (usually within 24 to 96 hr after surgery); therefore, the patient should be instructed about this risk and medications administered as prescribed to prevent acute attacks. The goal of chronic management of gout is to maintain serum uric acid levels below 6 mg/dl. At these levels chronic complications of gout are limited. abarticular goutPeriarticular gout.chronic goutlead goutperiarticular goutsaturnine goutLead gout.tophaceous goutgoutAn acute inflammatory joint disorder (ARTHRITIS) caused by deposition of monosodium urate monohydrate crystals around joints, tendons and other tissues, especially the near joint of the big toe. This occurs when there is excess uric acid in the body, probably as a result of a genetic abnormality. There is excruciating pain and inflammation. Treatment is by non-steroidal anti-inflammatory drugs (NSAIDS), such as indomethacin (indometacin) or naproxen, used early and throughout the attack. Colchicine is also effective. Gout can be prevented by the use of allopurinol which lowers the levels of uric acid in the blood. See also GOUTY TOPHI.gout(gowt) [MIM*138900]Patient discussion about goutQ. Is gout hereditary? My Mother has gout for a few years now. Is it hereditary? Does this mean I too will get it in the future? Q. How is gout treated? After a lot of tests, my Doctor concluded that I have gout. What treatment should I expect? Is gout curable? Q. what is the connection between gout and drinking cokes? There was an article in your magazine earlier this year about how drinking cokes could affect gout....can I get a copy of that artical? SymptomsMost hyperuricemic people are asymptomatic between acute attacks. When an attack of acute gouty arthritis develops, it usually begins at night with moderate pain that increases in intensity to the point where no body position provides relief. Low-grade fever and joint inflammation (hot, exquisitely tender, dusky-red or cyanotic joints) may be present. See: illustration TreatmentColchicine, nonsteroidal anti-inflammatory agents, or corticosteroids are used to treat acute gouty attacks. Long-term therapy aims at preventing hyperuricemia by giving uricosuric drugs such as probenecid, or xanthine oxidase inhibitors such as allopurinol. Patients with gout have a tendency to form uric acid kidney stones. The diet should be well balanced and devoid of purine-rich foods, e.g., anchovies, sardines, liver, kidneys, sweetbreads, lentils, beer, wine, and other alcoholic beverages, because these raise urate levels. Fluid intake should be encouraged. Patient careDuring the acute phase, bedrest is prescribed for at least the first 24 hr, and affected joints are elevated, immobilized, and protected by a bed cradle. Analgesics are administered, and hot or cold packs applied, depending on which the patient finds most helpful. The patient is taught about these measures. Colchicine, nonsteroidal anti-inflammatory agents, prednisone, or other prescribed drugs are administered. Allopurinol may be prescribed as maintenance therapy after acute attacks to suppress uric acid formation and control uric acid levels, thus preventing future attacks. Patients should be warned to report adverse effects of allopurinol, e.g., drowsiness, dizziness, nausea, vomiting, urinary frequency, dermatitis. A low-purine diet is recommended. The importance of gradual weight reduction is explained if obesity, which places additional stress on painful joints, is a factor. If soft-tissue tophi are present, e.g., near joints in fingers, knees, or feet, the patient should wear soft clothing to cover these areas and should use meticulous skin care and sterile dressings to prevent infection of open lesions. Surgery may be required to excise or drain infected or ulcerated tophi, to correct joint deformities, or to improve joint function. Even minor surgery may precipitate gouty attacks (usually within 24 to 96 hr after surgery); therefore, the patient should be instructed about this risk and medications administered as prescribed to prevent acute attacks. The goal of chronic management of gout is to maintain serum uric acid levels below 6 mg/dl. At these levels chronic complications of gout are limited. abarticular goutPeriarticular gout.chronic goutlead goutperiarticular goutsaturnine goutLead gout.tophaceous goutgoutAn acute inflammatory joint disorder (ARTHRITIS) caused by deposition of monosodium urate monohydrate crystals around joints, tendons and other tissues, especially the near joint of the big toe. This occurs when there is excess uric acid in the body, probably as a result of a genetic abnormality. There is excruciating pain and inflammation. Treatment is by non-steroidal anti-inflammatory drugs (NSAIDS), such as indomethacin (indometacin) or naproxen, used early and throughout the attack. Colchicine is also effective. Gout can be prevented by the use of allopurinol which lowers the levels of uric acid in the blood. See also GOUTY TOPHI.gout(gowt) [MIM*138900]Patient discussion about goutQ. Is gout hereditary? My Mother has gout for a few years now. Is it hereditary? Does this mean I too will get it in the future? Q. How is gout treated? After a lot of tests, my Doctor concluded that I have gout. What treatment should I expect? Is gout curable? Q. what is the connection between gout and drinking cokes? There was an article in your magazine earlier this year about how drinking cokes could affect gout....can I get a copy of that artical? |
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