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World J Rheumatol. Nov 12, 2014; 4(3): 62-71
Published online Nov 12, 2014. doi: 10.5499/wjr.v4.i3.62
Gout: A clinical overview and its association with cardiovascular diseases
Laura BE Kienhorst, Hein JEM Janssens, Matthijs Janssen
Laura BE Kienhorst, Matthijs Janssen, Department of Rheumatology, Rijnstate Hospital, 6880 TA Arnhem, The Netherlands
Hein JEM Janssens, Department of Primary and Community Care, Radboud University Medical Centre, 6525 GA Nijmegen, The Netherlands
Hein JEM Janssens, Department of Clinical Research, Rijnstate Hospital, 6880 TA Arnhem, The Netherlands
Author contributions: All authors contributed to this paper.
Correspondence to: Laura BE Kienhorst, MD, LLM, Department of Rheumatology, Rijnstate Hospital, PO Box 9555, 6880 TA Arnhem, The Netherlands. lkienhorst@rijnstate.nl
Telephone: +31-88-0055400 Fax: +31-88-0056612
Received: June 29, 2014
Revised: August 8, 2014
Accepted: September 4, 2014
Published online: November 12, 2014
Abstract

Gout is a common disease caused by the deposition of monosodium urate (MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis. The gold standard for diagnosing gout is the identification of MSU crystals in synovial fluid by polarization light microscopy. Arthritis attacks can be treated with anti-inflammatory medications, such as non-steroidal anti-inflammatory drugs, colchicine, oral prednisone, or intra-articular or intramuscular glucocorticoids. To prevent gout uric acid lowering therapy with for example allopurinol can be prescribed. When gout is adequately treated, the prognosis is good. Unfortunately, the management of gout patients is often insufficient. Gout is associated with dietary factors, the use of diuretics, and several genetic factors. Comorbidities as hypertension, chronic kidney disease, cardiovascular diseases, the metabolic syndrome, diabetes, obesity, hyperlipidemia, and early menopause are associated with a higher prevalence of gout. Xanthine oxidase and chronic systemic inflammation seem to play an important role in the pathophysiology of the association between gout and cardiovascular diseases. To prevent cardiovascular diseases gout patients must be early screened for cardiovascular risk factors.

Keywords: Gout, Review, Clinical, Cardiovascular diseases

Core tip: Gout is a common disease caused by the deposition of monosodium urate (MSU) crystals in patients with hyperuricemia, and characterized by very painful recurrent acute attacks of arthritis. The gold standard for diagnosing gout is the identification of MSU crystals in synovial fluid. Arthritis attacks are treated with anti-inflammatory medications, to prevent gout uric acid lowering therapy can be prescribed. When gout is adequately treated, the prognosis is good. Comorbidities as chronic kidney disease, cardiovascular diseases, and the metabolic syndrome are associated with gout. Gout patients must be early screened for cardiovascular risk factors.