Gout is an arthritic disease marked by recurrent acute attacks of pain, tenderness, redness, and swelling around the joints
and tendons caused by deposits of monosodium-urate crystals. Most gout cases are characterized by hyperuricemiaÑhigh levels of uric acid in the body that cause crystal build-up in the joint area. Other factors, such as
heredity, weight, and diet, may also play a role.
Gout affects more than one million Americans, mostly men between the ages of 40 and 50 years old. Primary gout appears to involve a heredity factor. A genetically sex-linked defect in purine metabolism leads to increased purine production, called the Lesch-Nyhan syndrome, resulting in a high uric acid concentration. Secondary gout develops as a
result of other causes, such as another disease. Excessive cell breakdown, as in hemolytic anemia, results in overproduction of urate. Diuretic drugs used to treat high blood pressure can also induce hyperuricemia and result in clinical gout.
Gout usually begins with pain and inflammation of a joint, often the big toe. To reduce the symptoms of acute attacks, colchicine, nonsteroidal antiinflammatory drugs, or corticosteroids are often prescribed. Excretion of urates by the kidney is aided by uricosuric drugs along with high fluids intake, which increase the urine output.