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In the Clinic |

Gout

Jennifer F. Wilson
Ann Intern Med. 2010;152(3):ITC2-1. doi:10.7326/0003-4819-152-3-201002020-01002
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For several thousand years, gout has been recognized as a very painful form of acute and frequently recurrent arthritis. Gout is increasing in prevalence because of the higher prevalence of obesity, a high-caloric Western diet, diuretic use, and an aging population (1). Gout currently affects more than 5 million persons in the United States alone (2). It is the most common cause of inflammatory arthritis in men, with the highest incidence in men in their forties. Gout is caused by monosodium urate (MSU) crystals formed in joints and tissues when serum urate levels exceed 404.5 µmol/L (6.8 mg/dL), the approximate saturation point in human biological fluids. Gout causes acute mono- or polyarticular arthritis as well as chronic inflammation, which leads to joint destruction. Treatment is aimed at lowering serum urate levels and reducing the inflammatory response to the MSU crystals. After few advances in treatment for several decades, several new drugs for prevention of gout are now available.

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