bone, joint, and muscle disorders
Gout
Causes of Gout
Uric acid is a by-product of the breakdown of the nucleic acids (ribonucleic acid [ Transcription and translation ] and deoxyribonucleic acid [ Abnormally high uric acid levels in the blood occur because of the following: Most commonly, from decreased elimination of uric acid by the kidneys or by the gastrointestinal system Sometimes, from consumption of too much purine-rich food, such as shellfish or red meat and/or alcohol, particularly beer Rarely, from production of too much uric acid Most often, the uric acid level in the blood becomes abnormally high when the kidneys cannot eliminate enough uric acid in the urine, even if kidney function is otherwise normal. This cause is usually determined by the person's genes. Too much uric acid in the blood can result in uric acid crystals being formed and deposited in and around joints. Conditions that can impair the kidneys’ ability to eliminate uric acid also include Some types of kidney disease Certain drugs Lead Poisoning None Consuming too much purine-rich food (such as shellfish, red meat, liver, kidney, anchovies, asparagus, consommé, herring, meat gravies and broths, mushrooms, mussels, sardines, and sweetbreads) can increase the uric acid level in blood. However, a strict low-purine diet lowers the uric acid level by only a small amount and is rarely sufficient therapy for people with gout. In past times, when meat and fish were scarce, gout was considered a rich person’s disease. Combining a high-purine diet with alcohol (particularly beer) or beverages containing high-fructose corn syrup can worsen matters because all of these beverages can increase the production of uric acid and interfere with its elimination by the kidneys. For unknown reasons, not all people who have an abnormally high level of uric acid in their blood develop gout. Beer (including nonalcoholic beer) and liquor Foods and drinks containing high fructose corn syrup Certain purine-rich foods (especially anchovies, asparagus, consommé, herring, meat gravies and broths, mushrooms, mussels, all organ meats, sardines, and sweetbreads; red meat, chicken, and shellfish all contribute some to elevated uric acid levels) Low dairy intake Certain cancers and blood disorders (such as Overview of Lymphoma , Certain medications (such as thiazide diuretics,cyclosporine,pyrazinamide,ethambutol, and nicotinic acid) Lead Poisoning None Obesity None Psoriasis None Radiation Therapy for Cancer None Chemotherapy and Other Systemic Cancer Treatments None Chronic Kidney Disease None Certain rare enzyme abnormalities Starvation High levels of uric acid in the blood often lead to high levels of uric acid in the joints. This process may then result in the formation of uric acid crystals in the joint tissue and the fluid within the joints, called synovial fluid. Gout most often affects the joints in the feet, particularly at the base of the big toe. Swelling, pain, and redness of the big toe due to gout is called podagra. However, gout also commonly affects other areas: the ankle, instep, knee, wrist, and elbow. Gout tends to affect these cooler areas because uric acid crystals form more readily in cool than in warm areas. Rarely, gout affects the joints of the warmer, central part of the body, such as the spine, hips, or shoulders. Sudden severe flares of gout, called acute gouty arthritis, can occur without warning. They may be triggered by An injury Illness, such as Overview of Pneumonia or another infection Surgery Start of treatment with certain medications (such as diuretics,allopurinol,febuxostat,probenecid, andnitroglycerin, particularlynitroglyceringiven by vein, which contains alcohol) that may suddenly change the uric acid level in the blood Consumption of large quantities of alcohol or purine-rich food 