Anatomy and Pathophysiology of Gout and Lupus Assignment

Anatomy and Pathophysiology of Gout and Lupus Assignment

Anatomy and Pathophysiology of Gout and Lupus
Introduction
Gout is an acute inflammatory arthritis with the potency to fully destroy the integrity of the joint leading to severe disability. It is termed as a “true crystal deposition disease” caused by formation of monosodium urate crystals in joints and other tissues. It is the common cause of inflammatory arthritis that has increased in prevalence in recent decades (Roddy and Doherty 2010). Gout normally results from the interaction of genetic, constitutional and environmental risk factors. It is more common in men and strongly age related. Both acute arthritis and chronic arthropathy (tophaceous gout) are considered under the rubric of gout (Mikuls and Saag 2006; Roddy et al. 2007). In a broader term, it can be defined as combination of events involving an increase in the serum urate concentration, acute arthritic attacks with monosodium urate monohydrate crystals demonstrable in synovial fluid leukocytes, and tophi which usually occurs in and around joints of the extremities. These physio-chemical changes either occur separately or in combination (Terkeltaub, 2003; Shai et al., 2010). Gouty arthritis accounts for millions of outpatient visits annually and the prevalence is rising. It affects 1-2% of adults in developed countries, where it is the most common inflammatory arthritis in men. Epidemiological data are consistent with a rise in prevalence of gout. Rates of gout have approximately doubled between 1990 and 2010. A number of factors have been found to influence rates of gout, including age, race, and the season of the year. In men over the age of 30 and women over the age of 50, prevalence is 2% (Eggebeen, 2007).
Anatomy and Pathophysiology
Gouty arthritis is one of the most painful rheumatic diseases and its incidence increases promptly with advancing age. In 75% of the patients, gouty arthritis initially strikes a single joint which is most commonly the big toe. In women gout develop in increasing numbers after menopause eventually at an incidence rate equal to that of men (Hootman and Helmick 2006). In elderly patients, an occurrence of gout is usually less spectacular than in middle age and often implies an upper extremity poly or mono articular presentation rather than the classic mono articular lower extremity picture commonly displayed by middle-aged men. In older patients, gout can be more likely the clinical picture of osteoarthritis or rheumatoid arthritis (Cassetta and Gorevic 2004). Gouty arthritis can be classified into four stages depending upon level of severity namely; (i) Asymptomatic Hyperuricemia: In this stage, a person has elevated blood uric acid levels but no other symptoms and therefore requires no treatment. (ii) Acute Gouty Arthritis: In this stage, hyperuricemia leads to deposition of uric acid crystals in joint spaces, leading to gouty attacks (iii) Interval / Intercritical: This is the stage between acute gouty attacks with no symptoms and (iv) Chronic Tophaceous Gout: where the disease leads to permanent damage (Bhansing et al. 2010).
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