gout care

gout care

gout… when is the right time to start uricacid lowering treatment? old gout treatment model doesn’t hold up m. alexander otto writing in rheumatologynews reported the old dictum of not starting uric acid lowering therapy during an acuteattack is wrong. dr. brian mandell reporting on a study from the cleveland clinic demonstratedtheir findings that showed that patients who were started on uric acid lowering therapyid the same whether the treatment was started during an attack or not. comment: old legends can die.

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gout is an inflammatory disease in which monosodiumurate crystals deposit into a joint, making it red, hot, tender and swollen within hours. when this happens, it’s called a gouty attack. the underlying cause is hyperuricemia—toomuch uric acid in the blood, which results in the formation of sharp, needle-like crystals,in areas with slow blood flow like the joints and the kidney tubules. over time, repeated gouty attacks can causedestruction of the joint tissue which results in arthritis. to understand where the uric acid comes from,let’s start with purines, which, together with pyrimidines, are nature’s most commonnitrogen-containing heterocycles. a heterocycle being any molecular ring orcycle with different types of atoms. purines, as well as pyrimidines, are key componentsof nucleic acids like dna and rna, and when cells, along with the nucleic acids in thosecells, are broken down throughout the body, those purines are converted into uric acid—amolecule that can be filt
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