Difference between revisions of "Gout"

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#redirect [[Crystals_in_body_fluids#Gout]]
'''Gout''' is a common benign affliction that can be disabling. It occasionally is seen by pathologists and can be groups with conditions with [[crystals in body fluids]].
 
==General==
*Classically afflicts the big toe - known as '''podagra'''.
 
Etiology:<ref name=Ref_PCPBoD8>{{Ref PCPBoD8|634}}</ref>
*Overproduction of uric acid ~ 10% of cases.
*Reduced excretion of uric acid ~ 90% of cases.
**May be genetic, e.g. URAT1 mutation.<ref name=omim607096>{{OMIM|607096}}</ref><ref>{{Cite journal  | last1 = Tin | first1 = A. | last2 = Woodward | first2 = OM. | last3 = Kao | first3 = WH. | last4 = Liu | first4 = CT. | last5 = Lu | first5 = X. | last6 = Nalls | first6 = MA. | last7 = Shriner | first7 = D. | last8 = Semmo | first8 = M. | last9 = Akylbekova | first9 = EL. | title = Genome-wide association study for serum urate concentrations and gout among African Americans identifies genomic risk loci and a novel URAT1 loss-of-function allele. | journal = Hum Mol Genet | volume = 20 | issue = 20 | pages = 4056-68 | month = Oct | year = 2011 | doi = 10.1093/hmg/ddr307 | PMID = 21768215 }}</ref>
**Renal failure.
 
==Gross/radiology==
*Radiologically may mimic ''anconeus epitrochlearis'' muscle.<ref>URL: [http://radiology.casereports.net/index.php/rcr/article/viewArticle/57/213 http://radiology.casereports.net/index.php/rcr/article/viewArticle/57/213]. Accessed on: 7 August 2011.</ref>
 
==Microscopic==
Features:<ref>URL: [http://pathologyoutlines.com/joints.html#gout http://pathologyoutlines.com/joints.html#gout]. Accessed on: 5 August 2011.</ref>
*Tophi (advanced)
**Reactive granulomatous inflammation.
***Surrounds fluffy (cotton candy-like) material.
**Fibrotic synovium.
**Aggregates of urate crystals.
 
===Images===
<gallery>
Image:Gouty_tophus_-_low_mag.jpg | Gouty tophus - low mag. (WC)
Image:Gouty_tophus_-_high_mag.jpg | Gouty tophus - high mag. (WC)
</gallery>
www:
*[http://www.archivesofpathology.org/na101/home/literatum/publisher/pinnacle/journals/content/arpa/2002/15432165-126.5/0003-9985%282002%29126%3C0621%3Apqcast%3E2.0.co%3B2/production/images/large/i1543-2165-126-5-621-f01.jpeg Gouty tophus - A. xray, B. Diff-Quick, C. Pap smear, D. polarized light, E. H&E (archivesofpathology.org)].
*[http://path.upmc.edu/cases/case205.html Gout - several images (upmc.edu)].
 
==See also==
*[[Crystals in body fluids]].
 
==References==
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Crystals in body fluids]]

Revision as of 02:23, 4 February 2014

Gout is a common benign affliction that can be disabling. It occasionally is seen by pathologists and can be groups with conditions with crystals in body fluids.

General

  • Classically afflicts the big toe - known as podagra.

Etiology:[1]

  • Overproduction of uric acid ~ 10% of cases.
  • Reduced excretion of uric acid ~ 90% of cases.
    • May be genetic, e.g. URAT1 mutation.[2][3]
    • Renal failure.

Gross/radiology

  • Radiologically may mimic anconeus epitrochlearis muscle.[4]

Microscopic

Features:[5]

  • Tophi (advanced)
    • Reactive granulomatous inflammation.
      • Surrounds fluffy (cotton candy-like) material.
    • Fibrotic synovium.
    • Aggregates of urate crystals.

Images

  • Gouty tophus - low mag. (WC)

  • Gouty tophus - high mag. (WC)

www:

See also

References

  1. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 634. ISBN 978-1416054542.
  2. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 607096
  3. ↑ Tin, A.; Woodward, OM.; Kao, WH.; Liu, CT.; Lu, X.; Nalls, MA.; Shriner, D.; Semmo, M. et al. (Oct 2011). "Genome-wide association study for serum urate concentrations and gout among African Americans identifies genomic risk loci and a novel URAT1 loss-of-function allele.". Hum Mol Genet 20 (20): 4056-68. doi:10.1093/hmg/ddr307. PMID 21768215.
  4. ↑ URL: http://radiology.casereports.net/index.php/rcr/article/viewArticle/57/213. Accessed on: 7 August 2011.
  5. ↑ URL: http://pathologyoutlines.com/joints.html#gout. Accessed on: 5 August 2011.
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