Female gout: clinical spectrum and uric acid metabolism

Article Abstract:

Gout is an illness that is caused by an inability to metabolize urate properly, resulting in the deposition of urate crystals in joints, causing an acute, painful arthritis. Approximately 95 percent of the patients with gout are men. Because of the small number of female gout patients, little information exists on the disease in women. The clinical course of gout in 37 women was compared with that of 110 men. Women were found to be nearly 10 years older than men when first diagnosed with gout, and were typically postmenopausal. Only five of the women studied had not undergone menopause when their gout was diagnosed. A greater proportion of the women had high blood pressure, and more of them were being treated with drugs in the diuretic category (which can precipitate attacks of gout). Too, a greater percentage of the women had mild kidney dysfunction, and the metabolic processes involved in gout originate in the kidneys. Alcohol abuse is strongly associated with gout in men, but this was not found to be the case with women. Patients with gout frequently form tophi, which are collections of urate crystals that cause joint deformities. Women were found to form tophi more frequently than men, and theirs were more often found in the joints of the fingers, while men's were more often found in the feet. Women with gout had higher urate levels in their blood than men. Thus, while gout results from the same metabolic abnormality in men and women, the disease manifests itself differently between the two sexes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Development and progression, Demographic aspects, Uric acid metabolism

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Inhibition of xanthine oxidase by allopurinol: a therapeutic option for ischaemia induced pathological processes?

Article Abstract:

Chemical reactions involving the enzyme xanthine oxidase produce free radicals, which are highly reactive molecules that can cause tissue damage, such as that resulting from ischemia followed by reperfusion. Ischemia is the deterioration of tissue due to an insufficient blood supply, and is associated with an accumulation of xanthines and hypoxanthines. Ischemia may be improved by reperfusion, a process of renewing the supply of nutrients to the deteriorating tissue. However, reperfusion can cause further tissue damage by supplying oxygen, which in the presence of high levels of xanthines results in the production of destructive free radicals. Metals such as iron and copper enhance free radical production, which may also originate from sources other than xanthine oxidase. Methods for monitoring free radical production are described. Free radicals can also contribute to inflammation of the joints by changing immune substances such as immunoglobulin G into complexes that activate inflammatory processes. Damage caused by free radicals may be prevented by inhibiting the production of these highly reactive molecules, and by removing free radicals using specific scavenger-like substances. The drug allopurinol prevents free radical production from xanthine oxidase, acts as a free radical scavenger, and prevents the depletion of energy sources such as adenine nucleotides during ischemia. Further studies will be required to determine the mechanisms and treatment of free radical tissue damage. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Physiological aspects, Ischemia, Xanthine

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Efficacy of allopurinol and benzbromarone for the control of hyperuricaemia. A pathogenic approach to the treatment of primary chronic gut

Article Abstract:

Benzbromarone effectively lowers plasma urate concentration in many patients with primary chronic gout. Gout is a metabolic disorder characterized by impaired urate excretion, and some patients develop painful urate crystal deposits in their joints. Researchers treated 86 patients with allopurinol or benzbromarone. Average plasma urate concentrations fell about 3 mg/dl in patients taking allopurinol, and about 5 mg/dl in those taking benzbromarone. Benzbromarone therapy effectively reduced plasma urate levels in every patient treated.

Evaluation, Drug therapy, Uricosuric agents

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