Gout Syndrome Essay

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Gout is a “disorder of metabolism that allows uric acid or urate to accumulated in the blood and tissues”(Rothschild, 2015, p. 3). It is more common in men than in women and has a higher incidence in 70 to 79 years of age. The gout syndrome is “ caused by alteration in purine metabolism, the end product which is uric acid. This results in hyperurecemia and in the deposition of urate crystals in various tissues (Woo & Wynne, 2011, p. 869). Hyperuricemia can occur due three mechanisms:
1. Decreased excretion (underexcretors): Accounts for most cases and occurs when altered uric acid excretion results from decreased glomerular filtration (can contribute to the hyperurecemia of renal insufficiency), decreased tubular secretion (seen in patients with acidosis when accumulated organic acids compete with urate for tubular secretion), or enhanced tubular reabsorption (when distal to the site of secretion, thought to be responsible for hyperuricemia observed with diuretic therapy and diabetes insipidus) .
2. Increased production (overproducers): Occurs in a small number of patients and is caused by diets rich in purines (liver, kidney, meat gravies, broths, sardines, sweetbreads) or increased purine nucleotide breakdown. It can also be caused by increased nucleoprotein turnover in hematologic conditions (lymphoma, leukemia, hemolytic anemia)
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A gout attack is characterized by the presence of urate crystals in the soft tissues and synovial tissue and is often precipitated by sudden increase, or sudden decrease in serum urate levels. Symptoms of acute gout are the “sudden onset of pain, erythema, limited range of motion, and swelling in the involved joint, usually involving the first metatarsal joint of the great toe”(Woo & Wynne, 2011, p. 869). Acute gout can be observed in four

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