Case Of Gout Research Articles

Some aspects of the epidemiology of gout. Sex and race incidence.

Gouty arthritis is generally considered to be a disease of the middle-aged white man. Although there have been reports of a relatively high incidence in women, 1,2 in most series of cases, women have constituted less than 10% of the total. 3-5 Most authorities also stress the relative rarity of this disease in the Negro. 4-6 The apparent population characteristics of a disease are often affected by the nature of the group served by a hospital in which a study is made, and by other factors influencing case selection. Our experience with 74 cases of gout seen at two large municipal hospitals during the past four years revealed some rather striking divergences from the usual sex and race incidence reported for this disease. It is the purpose of this report to present our observations on the incidence of gout in women and in Negroes, and to show that the characteristics

A Case of Gout

A Case of Gout

痛風の一例

A report is made of typical case of gout found in a 32 year old male with deformity in the extremities joints and 28 nodules in the earlobes and extremities.

A Case of Gout

A Case of Gout

Reversal of renal insufficiency in gout; report of a case treated with probenecid (benemid).

RECOGNITION and treatment of reversible disease is the primary function of the physician. This is particularly true when pathological processes involve a vital organ, such as the kidney, where progression of the lesions may lead to functional insufficiency and death. It is the purpose of this paper to review the problem of the renal complications of disturbed uric acid metabolism in gout and to present a case of severe primary gout in a young man with renal insufficiency in whom return to normal renal function occurred during treatment with probenecid (Benemid) over a 34-month period. During this time marked decrease in urate deposits elsewhere besides the kidney occurred, such as visible tophi, and improvement in the state of the clinical gouty arthritis also was seen. It is felt that the observation of the improvement in the renal function of this patient aids in clarifying the pathogenesis of the renal failure

A Case of Gout

A Case of Gout

A case of severe gout in a woman aged 27.

A case of severe gout in a woman aged 27.

The treatment of migraine, gout, and Heberden's nodes; a factor common to these conditions.

1. A factor common to cases of Migraine, Gout and Heberden’s Nodes is a greater than normal sensitiveness to the higher or readily soluble carbohydrate foods. 2. In Migraine cases there is solely a carbohydrate sensitiveness not related to protein or other foods. 3. In cases of Gout and Heberden’s Nodes there is a definite sugar/nitrogen relationship, the sugar factor being the important one. 4. The dietary regime for treatment of the above is described herein. 218 E. University Parkway.

Some Cases of Gout

Some Cases of Gout

Essential lipemia, acute gout, peripheral neuritis, and myocardial disease in a Negro man; response to corticotropin.

ESSENTIAL lipemia is a rare disease. a recent review, Movitt, Gerstl, Sherwood, and Epstein 1 were able to find 14 previously reported cases and added 3 of their own. While the occurrence of xanthomas in the skin, lipemia retinalis, hepatomegaly, and splenomegaly was frequent in this series, the occurrence of gout or peripheral neuritis is not mentioned. These authors stated: In contrast with familial hypercholesteremic xanthomatosis, premature arteriosclerosis and atheromatosis have not been observed in idiopathic hyperlipemia of adults. Wolfson, Cohn, Levine, Rosenberg, and Hunt 2 mentioned a single case of gout associated with idiopathic lipemia and stated that, with the exception of this case, the presence of hypercholesteremia is not characteristic of gout. Because the case to be reported adds a second instance of gout in relation to essential lipemia, as well as an additional apparently related neurologic and cardiac syndrome not previously described, and because of the

Mobilization of gouty tophi by protracted use of uricosuric agents

A case of advanced tophaceous gout exhibiting unequivocal reduction in size of many tophi in the course of protracted uricosuric therapy is described. It may be possible by proper use of uricosuric agents not only to minimize new tophus formation but also to cause the disappearance of old established tophi.

Effects of adrenocorticotropic hormone (ACTH) in gout

1. 1. ACTH effected a very rapid and satisfactory response in the local and systemic manifestations of acute gout in seven of eleven cases treated, including one patient refractory to colchicine. ACTH therefore appears to be a useful agent in the therapy of acute gout. In many of these patients, however, ACTH was not convincingly superior to colchicine, and in four instances colchicine terminated attacks responding unsatisfactorily to ACTH. Unlike colchicine, ACTH is not suitable for prophylactic use in the prevention of acute gouty attacks. 2. 2. Exacerbation of symptoms occurred in four patients following discontinuance of ACTH therapy after a satisfactory response. Such exacerbations usually suggested re-exhibition of the underlying disease upon termination of the suppressive effects of ACTH rather than initiation of a new attack of acute gout. The conjoint and continued prophylactic use of colchicine seems rational in patients subject to frequent recurrences. 3. 3. Acute gouty arthritis developed only once in eight cases of interval gout when ACTH was given in full dosage and then abruptly discontinued. 4. 4. In the prevention and treatment of chronic tophaceous gout, the use of ACTH is neither feasible nor desirable at present. Salicylates and carinamide are at least as effective uricosuric agents, are readily available and orally administered. 5. 5. The available evidence does not appear to justify the view that the pituitary and/or adrenal glands play a central role in the pathogenesis of gout.

SCLERAL DISEASE IN RHEUMATOID ARTHRITIS

Inflammation of the sclera and of the episclera, the latter first called subconjunctivitis by von Graefe, have long been known to be associated with diseases of the articular structures of the body. Hutchinson1in 1885, Fuchs2in 1895 and Wagenmann3in 1897 reported cases of gout in which episcleritis was a notable complication. Wood4in 1936 found crystalline deposits in the sclera of a gouty patient who manifested active scleritis. As recently as 1924, Rateau5reported an interesting case in which sclerotenonitis was the prodromal symptom of an attack of rheumatic fever. In 1938 Verhoeff and King6presented a case of rheumatoid arthritis in which an eye was removed because of an inflammatory perforating scleral lesion. This eye was histologically examined in great detail. These authors analyzed 14 previously recorded cases of a similar nature in which the lesion was designated by the name

The Peripheral Circulation in Chronic Rheumatism

A series of cases of rheumatoid arthritis, osteo-arthritis, gout and fibrositis have been investigated by means of the sedimentation rate, Arneth count, saline absorption test, glucose tolerance test, and direct observation of the capillaries, in order to correlate any abnormality of the peripheral circulation with the type and activity of the disease.The sedimentation rate test, in which a wide bore tube was used, was of great value as an estimation of activity in the rheumatoid arthritic cases, but a small group showed a normal reading. In the gouty subjects it was usually low but was liable to vary greatly within a short time. In the osteo-arthritic and fibrositic groups it was normal.The Arneth count did not parallel the sedimentation rate; it was usually normal in the gouty subjects but showed abnormalities in the rheumatoid arthritics and sometimes in the osteo-arthritics (a shift usually to the left, but sometimes to the right).The saline absorption test was valueless except in cases of gross circulatory disturbance.The glucose tolerance test, although producing some abnormal curves, in both the osteo-arthritic and the rheumatoid arthritic groups gave normal curves, taking an average of a large number of cases.Observation of the capillaries-notes being taken of their number, shape, &c., with a drawing eyepiece and photographs-showed a wide variation in normal individuals. This was so remarkable that the only clear-cut findings were a slight increase in tortuosity in the osteo-arthritic group-probably due to the increase in the average age of this group-and an increase in the visibility of the full-length of the capillary loop and of the basal meshwork in the rheumatoid arthritics, probably due to trophic thinning of the epidermis.

GOUT

It has been known for many years that there is some relationship between gout and uric acid, and many investigations of the uric acid metabolism of gouty patients have been carried out.¹Because the number of cases of gout reported throughout the country is increasing, such studies are of especial interest at the present time. Some of the recent studies have shown that the methods of diagnosing the disease are apparently not wholly satisfactory, for in 100 cases an average period of fifteen years elapsed between the first appearance of symptoms and the establishment of the correct diagnosis.²The differentiation of gout from chronic arthritis, when joints other than the big toes are involved, seems to be particularly difficult. We feel that the experiments reported here may serve as a basis of a useful test in helping to establish a correct diagnosis. A number of workers have found

An unusual Case of Chronic Gout. — X‐Ray Diagnosis of Gout1

An unusual Case of Chronic Gout. — X‐Ray Diagnosis of Gout¹

The significance of the uric acid, urea and creatinine of the blood in early and late nephritis

Typical cases of gout show, as a rule, blood uric acid values from 2 to 5 times the normal. The amounts of urea and creatinine are normal or in the case of urea, only slightly above normal. Many ea...

A Case of Gout, with Uratic Tophi, in a Boy Aged 14

A Case of Gout, with Uratic Tophi, in a Boy Aged 14

A Case of Gout, with Large Tophaceous Deposits, in a Mahommedan

A Case of Gout, with Large Tophaceous Deposits, in a Mahommedan

Report of a Case of Chronic Gout, with Observations on Gout in General

Report of a Case of Chronic Gout, with Observations on Gout in General