One of the groups of rheumatic diseases includes the so-called microcrystalline or metabolic arthritis. One of these arthritis is gout, the signs and manifestations of which have been known since the time of Hippocrates. This disease occurs due to impaired metabolism of uric acid with its high content in the blood, as well as pathological deposition of crystals (urates) in the tissues. Therefore, the symptoms of gout are clinically manifested by the occurrence of acute arthritis, as well as the formation of tofus, specific gouty nodes.
The name of the disease was given by the Greeks. The first known description of this disease to date was given by the Greek physician Saranus. This ailment affected Macedonian, Newton and many other famous historical figures.
The number of people with gout symptoms every year increases. Rather, it can be associated with improving the quality of life and nutrition. No wonder this disease is also called "the disease of aristocrats."
The problem of this disease is its late diagnosis, most often in the chronic stage, when not only the joints are involved in the disease process.
The first signs of gout often begin to bother middle-aged men. But recently, the disease has significantly "rejuvenated." He can be found in thirty-year-old young people. In the majority of those who applied for help, an attack of gout begins with the appearance of pain and swelling of the first (big) toe. This is a classic option. The remaining pains are noted in other joints of the foot, as well as in large joints of the limbs.
To understand the pathogenesis of the disease, you need to have an idea about the normal metabolism of uric acid. In humans, it is the result of cleavage of purines. In our body, the sources of the formation of such an acid are the products we consume, which contain purines (meat, legumes, red wine, fish, etc.), cell nucleoproteins. Uric acid is excreted from the body through the intestines, being split by the intestinal flora, and with urine (its main part).
Causes of the disease
It is known that the symptoms of gout appear when a combination of excess uric acid in the body and a decrease in its excretion in the urine. An increase in acid formation may result from excessive consumption of products containing purines and an increase in the internal synthesis of purines in the body.
Primary hyperuricemia and secondary are distinguished. Gout occurs as a result of the first option. A secondary increase in uric acid in the blood is usually a consequence of renal failure, myeloma, some types of leukemia and anemia, and also manifests itself when certain medications are used, for example, diuretics.
Excessive acid content in the blood leads to its deposition in organs and tissues. In the form of sodium urate, it is deposited in synovial bags, penetrates into the synovial fluid. Urate enters the cartilage, causing inflammation and damage.
Symptoms of Gout
As noted above, the classic option is to damage the joint of the big toe. By itself, an excess of uric acid in the body does not cause any symptoms, and damage to this particular joint draws attention. Often, an outbreak is triggered by overeating, hypothermia, trauma or infection. Often, an attack of arthritis occurs against the background of complete well-being, although predecessor symptoms are sometimes noted, such as frequent mood swings, excessive irritability, etc.
Usually pains appear at night and suddenly. The pain is so severe that it is impossible to touch the joint. At the same time, edema and redness appear. After one to two days the pain goes away. A characteristic feature of gouty pain is its sudden and abrupt start and the same sudden end. If large joints are affected, then the clinical picture resembles phlegmon. Tofuses can form in the joints. They are tubercles located under the skin or in the joint (deposits of urate). The blood contains an increased content of uric acid.
Treatment
In an acute attack, colchicine, anti-inflammatory, analgesic drugs (NSAIDs) are used. A mandatory requirement is to follow a diet with the exception of meat, alcohol, and offal from the diet.
The second step is the prescription of drugs that reduce the formation of uric acid in the body. Such a drug is allopurinol or its analogues. This drug is used for continuous and long-term treatment ..