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1. Four stages of Gout

1. Four stages of Gout. Asymptomatic hyperuricemia elevated urate levels without symptoms of gout, nephrolithiasis , or kidney stones Majority of people with hyperuricemia never develop symptoms of uric acid excess Acute Intermittent Gout (Gouty Arthritis )

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1. Four stages of Gout

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  1. 1. Four stages of Gout • Asymptomatic hyperuricemia • elevated urate levels without symptoms of gout, nephrolithiasis, or kidney stones • Majority of people with hyperuricemia never develop symptoms of uric acid excess • Acute Intermittent Gout (Gouty Arthritis) • symptoms: sudden onset of severe pain, inflammation, limited range of motion, and warmth at the affected joint(s). • slight fever, leukocytosis, elevation of ESR, and elevation of CRP • 90% of first attacks are monoarticular with first metatarsophalangeal joint, known as podagra. • Left untreated, the symptoms are self-limiting but may take up to 21 week to subside • Intercritical Gout • After recovery from an acute gout flare, the patient enters an asymptomatic phase of the disease. • This interval between gout flares: as intercritical or interval gout. • Later, recurrence of acute gout may become more frequent and polyarticular involvement. • Chronic Tophaceous Gout • Tophi are usually present after 10 to 20 years of inadequately treated chronic gout. • Visible tophi occur in 12% of patients after 5 years of gout and in 55% of patients after 20 years. • most common sites of tophaceous gout: olecranonbursae (elbow) and the joints of the hand and feet.  Other sites: the helix of the ear, the Achilles tendons, and the knees. www.slideworld.com/.../Guideline-for-gout-management

  2. 2. Conditions w/c contributes to hyperuricemia ntuh.sicu.org.tw/upload/CASE.../Acute%20Gout%20Attack

  3. 3. Renal involvement in chronic gout • uric acid calculi • chronic urate nephropathy • acute uric acid nephropathy • Renal insufficiency • Polycystic kidney disease • Lead nephropathy www.slideworld.com/.../Guideline-for-gout-management

  4. 4. Outline management of uncomplicated acute gout

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