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 INTRODUCTION

Common metabolic disease

secondary to a purine metabolism disorder:

 Excess uric acid: hyperuricemia

1. Hyperproduction

2. Failure to eliminate

 Precipitation of sodium urate crystals Joints: gouty attacks

(Acute gout) Soft parts (tophus), kidney and joints: Gout

chronic

 Functional (articular) and vital (renal) prognosis

 

EPIDEMIOLOGY

 Frequent hyperuricemia (5-15% of the population):

> 70 mg/l (M) > 60 mg/l (F)

 Gout: 0.5% (2% after 60 years)

 Men in 90% of cases Women after menopause

 Most often between 30-50 years old

 

ETIOLOGIES

 Primary gout:

1.Idiopathic: 98% Overfed plethoric man (bon vivant) Mechanism unknown

2. Enzyme deficiency: HGPRT Total: Lesh-Nyhan Partial: early gout (20-year-old man) and severe (renal involvement+++)

3. Hyperactivity of PRPP synthetase

 Secondary drops:

1. Chronic renal failure

2. Hemopathies

3. Extensive psoriasis

4. Iatrogenic: (Diuretics + + + + + Low dose aspirin Chemotherapy Pyrazinamide, ethambutol)

 

The biological assessment

 VS, NFS

 Hyperuricemia

 uraturia

 Synovial fluid: very inflammatory, 5000 GB/mm3 (PNN) (Sometimes 50,000 to 100,000)

Sodium urate crystals

Gouty tophi in the auricle

 

Diet

 

References :

https://www.docteur-lequere.fr/actualites/item/29-hyperuricemie-et-goutte

https://www.creapharma.ch/goutte.htm http://www.rhumato.info › docs › LA GOUTTE

HAL Id: dumas-03160876 https://dumas.ccsd.cnrs.fr/dumas-03160876