Medicina, Vol. 56 No. 2, 2020.
Pregledni rad
https://doi.org/10.21860/medflum2020_237297
Gout, contemporary insight into an ancient disease
Nadica Laktašić Žerjavić
; Medicinski fakultet, Sveučilište u Zagrebu, Klinika za reumatske bolesti i rehabilitaciju, Klinički bolnički centar Zagreb, Kišpatićeva 12, 10000 Zagreb, Hrvatska
Nadia Hoteit
; Medicinski fakultet, Sveučilište u Zagrebu, Šalata 3, 10000 Zagreb, Hrvatska
Dragica Soldo Jureša
; Medicinski fakultet, Sveučilište u Zagrebu, Klinika za dijabetes, endokrinologiju i bolesti metabolizma Vuk Vrhovac, Klinička bolnica Merkur, Dugi dol 4a, 10000 Zagreb, Hrvatska
Sažetak
Gout is a chronic metabolic but at the same time inflammatory rheumatic disease which develops as a cosequence of increased urate concentration and deposites of monosodium urate crystals. The main cause of hyperuricaemia is renal urate underexcretion. In the pathogenesis of the inflammatory response to urate crystals, the phagocytosis of crystals by the macrophages is important, leading to activation of the NLRP3 inflammasome and the consequent release of the major proinflammatory cytokine interleukin 1β. Inadequate long-term treatment of hyperuricaemia leads to the development of chronic gout, which causes significant structural joint damage, disability and reduced quality of life. Therefore, long term urate lowering treatment aimed at maintaining urate concentrations < 350 umol/L in early disease and < 300 umol/L in chronic tophaceous disease is mandatory. Acute arthritis in gout, or a flaire in chronic arthritis should be treated with anti-inflammatory drugs: non-steroidal anti-inflammatory drugs, colchicine or glucocorticoids, mainly as a monotherapy. Patients with gout should be closely monitored for associated comorbidities, especially renal disease, hypertension, metabolic syndrome, and elevated cardiovascular risk.
Ključne riječi
comorbidity; crystal arthropathies; gout; hyperuricaemia
Hrčak ID:
237297
URI
Datum izdavanja:
1.6.2020.
Posjeta: 5.497 *