Etiology and pathogenesis

 Status hyperuricemia

High uric acid levels may be the result of increased production or decreased uric acid excretion of uric acid by the kidneys. 80% - 90% of patients with primary gout condition decreased uric acid excretion through the kidney tubules despite normal renal function, possibly due to reduced filtration, reabsorption increased or decreased excretion, but the mechanism The most important is still unclear.

High uric acid levels may be secondary to some disease (kidney, bone marrow proliferative diseases, obesity, alcoholism and drug).

Approximately 10% - 20% of patients with primary gout is caused by increased synthesis of purines lead to increased production of uric acid. There are four types of genetic disorders of purine synthesis are: (1) Increase the PRPP synthetase enzyme activity, (2), glucose-6-phosphate deficiency dehydrogenase, (3) lack of enzyme fructose-1-phosphate aldolase, and (4 ) HGPRT deficiency.

  AICD causes increased blood uric

By proposing the transfer cycle promise uric acid, hyperuricemia has many causes. The first is to increase supply through diet, drinking (beer, wine, organ, dog meat, meat Bu ...), too, proposing increased synthesis (genetic disorders ...), and reduced training proposing Too Waste. Or combination of both mechanisms has increased synthesis reduces uric acid excretion in the urine.

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Oriental medicine, explaining why cause gout!

Gout (gout) is arthritis is common in men with symptoms of pain and swelling in the big toe, ankle, elbow ...

According to Western medicine, the cause of gout is caused by increased uric acid in the blood, causing deposition of uric acid crystals or monosodium urate salts around joints (typically the knuckles feet) in the synovium, bone at the level of cartilage and cause gout attacks. If left untreated, high uric acid will form lasting in subcutaneous tophi, ear cartilage. Or can cause deposition of urate salts in the kidneys and cause kidney stones.

As agreed, gout  , also known as gout are derived from three groups of causes are:

+ Due to low seizures. Feng (wind) common in the spring. Performer can easily damage (liver), "can all weight" so prone to seizures, pain in bones and joints.

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The cause of gout

Gout is detected in 400 BC, but always late nineteenth century, Schelle, Bargman and Wollaston new found role of uric acid in the cause, so also known as gout arthritis uric acid.
Normal uric acid levels in the blood is kept stable at concentrations below 70 mg / l (420 micromoles / l) for men; 60 mg / l (360 micromoles / l) for women and is kept at a constant level by a balance between the synthesis and excretion of these substances. Any cause imbalance process (increased synthesis or decreased excretion) were increased uric acid in the blood.

1. Uric Acid
• A compound C, N, O, H formula C5H4N4O3
• Ease of forming urate salts: ammonium urate, sodium urate.

• Tan restrictions in the country. Alkaline environment increases the solubility of uric acid environment and vice versa acid reduces uric acid solubility.

• In the body, uric acid is formed by the breakdown of purines exogenous (food) and endogenous purine (by cell decomposition). Join the formation of uric acid with the role of men: nuclease, xanthinoxydase, hypoxanthin - guanine - phosphoribosyl - transferase (HGPT).

• Uric acid is excreted primarily by the kidney, and the rest is excreted in the digestive tract and other pathways.

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The factors that trigger gout attacks over image

Gout is a joint disease of the crystal , caused by uric acid blood and synovial membrane deposition in joints causing gout attacks. The factors that increase uric acid in the blood rapidly and usually causes a sudden onset of acute gout attacks such as the following image:
1. Due to the stress

2. Due to injury

3. Due to surgery

4. Due to serious illness

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Top 10 causes of gout

Gout is increasingly common in modern society. What are the causes of this disease?

1. Families who have a history of gout, you are at risk for the disease.

2. Men are at risk of gout than women.

3. Drinking too much alcohol also susceptible to gout.

4. People who have a weight problem prone Gout. The more obese people, the higher the possibility of infection.

5. Use a processed food increases the risk of disease.

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The drug causes hyperuricemia

  Gout is a disorder of purine metabolism with the result hyperuricemia. There are many causes of hyperuricemia. Within the scope of this article, please refer to the cause may have cause hyperuricemia is used by some drugs decreased excretion of uric acid by the kidneys as aspirin, phenylbutazone prolonged low dose, the majority of drugs diuretics (spironolactone group minus) prolonged use; tuberculosis drug as ethambutol, pyrazinamide ...

Group diuretics:

Diuretics are indicated for the treatment of edema of heart failure, cirrhosis, chronic or acute renal failure, nephrotic syndrome ... be used alone or in combination with other antihypertensive drugs to treat hypertension pressure. Most of the group diuretic drugs, whether thiazide diuretic group; loop diuretic furosemide ... prolonged use can cause hyperuricemia. The diuretic reduces uric acid excretion by the kidneys, leading to increased levels of this substance in the blood.

These include some diuretics cause hyperuricemia as hydrochlorothiazide, thiazide diuretics and similar groups other thiazide (chorthalidone, metolazone); loop diuretic furosemide, bumetanide, ethacrynic acid; diuretic indapamide group; ... Only amiloride diuretic spironolactone group is not affecting uric acid excretion can be prolonged in patients with gout or hyperuricemia condition asymptomatic; while most of the other medications should be careful when using, especially if you have prolonged use.

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Gout and the risk factors.

Hyperuricemia

If only pure hyperuricemia, gout is not, this is just a state of purine metabolic disorders, increased uric acid in the blood (above 7 mg% or above 420mmol / L) but not pathogenic. Hyperuricemia alone have a high rate: from 4 to 14% of the population (depending on ethnicity, national). This situation can occur very early, even at puberty. The majority of cases, this situation absolutely does not cause symptoms, often only accidentally discovered while testing.

Hyperuricemia is considered to be important risk factors of gout. Blood uric acid levels higher, more likely to be gout.

Approximately 5-10% of people with hyperuricemia will become gout patients in the late 3rd onwards (> 35 years).

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Why Gout growing

  Gout was discovered from ancient times. Today, gout is more concerned by the increase of the disease. Food and genetic factors play a role in the pathogenesis of primary gout . Increase the risk of heart disease and changes in the treatment of gout.

Gout has been known since long. Percentage of gout is increasing in both the US and European countries and many other countries such as Japan, China and New Zealand. Percentage of gout in the UK and Germany in 2000 - 2005 was 1.4% and in the US in 1996 was 0.94%. The proportion of the population of gout in 5 major cities in western China accounted for 1.14%. China is a country with a developing economy, gout here are related to obesity, hypertension, consumption of meat, fish and wine.

In our country, nowadays very common disease in the joints and base clinic treating osteoarthritis. All year round, we are experiencing gout patients in the hospital. In patients with chronic gout illness is severe: the deformed joints, movement very difficult, painful joints due to acute inflammation of multiple joints, decreased quality of life, treatment costs due to expensive treatment the comorbid conditions such as dyslipidemia, hypertension, diabetes, joint infection, kidney failure, pancreatitis ...

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Genetic relationship and gout

One reason why millions of people worldwide suffer from aches in the joints, also known as gout , may have been discovered by scientists.

In the UK, the number of gout has increased every year and causes supposedly because they eat unhealthy.

However, a genetic test on a sample of more than 12 thousand people, published in the journal Nature Genetics, found that a gene may be the cause that led to this increase.

The researchers at the MRC Human Genetics Unit Unit, in the city of Edinburgh, said genes and proteins that control gene, may one day be home to research to produce new drugs to treat this disease .

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Fresh water increases the risk of gout

The men drink more than 2 cups sweetened soft drinks per day will increase 85% and the risk of gout is more obvious symptoms of gout than those who drank less than one cup of whole months.

The number of cases of gout in the US has doubled in recent years and fructose, a form of sugar, is said to be the cause. In the UK, approximately 1.5% of the population are suffering from gout and the number is constantly increasing in 30 years. Symptoms of gout include pain and swelling of joints, mainly in the lower extremities. The phenomenon is caused when the blood uric acid crystallizes and go into the match.

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Why drink a lot of alcohol prone gout

  Gout is a form of arthritis caused intense pain in the big toe or ankle, common in men. One of the reasons that the eyebrow whiskers become the object of attack of the disease because they often drink more alcohol. Thus, the drink has been nothing gout diet ?

1. Beer - supply of uric acid causes gout

Uric acid is the major cause to gout. Uric acid is produced by the breakdown of purines and protein is excreted from the body through urine. The habit of using food or drinks rich in purines lead to increased uric acid in the blood. In addition to nutritious foods such as beef, fish, shrimp, crab, animal viscera ..., beer is considered too large supply of human purine cause increased blood uric acid and gout.

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Beer - a causative agent of gut

After a series of questions about the influence of alcohol for gout , the last American scientists have demonstrated this relationship is real. In particular, beer is the most dangerous threat, because it contains a special ingredient than any alcoholic beverages do.

For years, people believed that alcohol has the ability to stimulate the body to produce a substance called uric acid. The accumulation of this substance in the joints leads to gout, also known as gout, chronic destruction of the joints, causing gout arthritis attacks the expression levels with increasing redness and soreness.

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Causes Gout - The role of uric acid

Gout is a metabolic disorder related to increased production or decreased excretion of uric acid in the body. We can say the direct cause of gout is caused uric acid, a byproduct generated by the breakdown of purines. In normal people, the amount of uric acid in the blood is maintained at a fixed 5mg% of men and 4 mg% in women, depending on age and change. To balance the daily uric acid, uric acid is excreted mainly in the kidney into the urine and feces, and partly through other avenues.

One reason, levels of purines in the body increases, our metabolism increases uric acid. When the body produces too much uric acid or the acid waste too little urine uric acid levels in the blood increased, uric acid metabolism increases urate salts leads to the deposition of urate crystals of salt sharp needles in the joints, cartilage, bone, held under the skin, causing inflammation and swelling and symptoms at the deposition location.

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Causes of gout

Gout (Gout) is a metabolic disorder related to increased production or decreased excretion of uric acid in the body. We can say the direct cause of gout is caused uric acid, a byproduct generated by the breakdown of purines.

In normal people, the amount of uric acid in the blood is maintained at a fixed 5mg% of men and 4 mg% in women, depending on age and change. To balance the daily uric acid, uric acid is excreted mainly in the kidney into the urine and feces, and partly through other avenues.

Causes gut

Acid levels in the blood is the cause of gout

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CAUSE INCREASED gout

Gout or gout have dramatically increased in the past two decades. Here are the cause of the rise in gout in recent times.

In increment gout

What Causes Gout causes increased disease?

Obesity

Obesity is one of the causes of gout. Obesity increases the blood uric acid and urinary uric acid reduces waste, combining both innocent cause hyperuricemia. According to recent statistics, 50% of patients with gout excess of 20% of body weight.

Hyperlipidemia

The combination of increased blood fat and blood uric acid levels were ascertained. Up to 80% of blood fats can increase the coordination of hyperuricemia and 50% - 70% of patients with gout have included high cholesterol.

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CAUSE OF gout
Gout (gout) among crystal deposition disease (crystalline deposition disease). And uric acid is the culprit.

Specifically in this disease monosodium urate crystal deposition in the bursae, tendons due to increased uric acid in the blood ... caused waves of peripheral arthritis inflammation of the joints that is special or limbs occurs in the toes the. Inflammation is caused by human leukocytes is like the soldiers fighting in the body go clean the crystals.

Uric acid causes gout

Uric acid is the cause of gout

Inflammation can be repeated several times causing deformity if not treated. Not all people with high uric acid in the blood is being gout however if uric acid levels in the blood and it lasts as long as there is the risk of gout.

So why was increased uric acid in the blood? It is due to be careful not to waste uric acid or by the body to make too much (due to diet, disease, such as blood cancer types lim Phom, hemolytic anemia, psoriasis ..) or by abnormalities in the cycle this creates acid.

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Gout Symptoms - Causes

The cause of gout is caused by high levels of uric acid, called hyperuricemia when uric acid levels exceed the maximum limit of solubility of urate in plasma, namely: Over 420 μmol / l for men and more than 360 μmol / for women.

 

The cause of hyperuricemia is more, it is divided into three categories as follows:

+ Primary gout (mostly encountered this type): This type is usually familial factors, onset is usually caused by eating too many foods containing purines's often accompanied by drinking too much alcohol. Common mainly in middle-aged men and few women in the postmenopausal age.

+ Secondary gout: As a result of hyperuricemia due to excessive cell targets (myelogenous leukemia, chronic hemolytic anemia, extensive psoriasis ...) or renal failure.

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Causes Gout

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Causes of gout

Gout is caused by a build-up of uric acid in the blood. Uric acid is a waste product that forms when the body breaks down chemicals in the cells known as purines.
Most uric acid is removed from the body through the kidneys. A small amount is removed through the digestive system.
 

Sodium urate crystals

Uric acid usually remains dissolved in your blood and passes through your kidneys into your urine so it can be passed out of your body.
If you produce too much uric acid or excrete too little when you urinate, the uric acid will build up and may cause microscopic crystals of sodium urate to form, usually in joints or surrounding tissue.
The crystals may spill over from the joint cartilage into the joint space, where they trigger a reaction from the soft lining (synovium), which produces the intense pain and inflammation associated with a gout attack.

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You're more likely to develop gout if you have high levels of uric acid in your body. Factors that increase the uric acid level in your body include:

• Diet. Eating a diet that's high in meat and seafood and high in beverages sweetened with fruit sugar (fructose) promotes higher levels of uric acid, which increases your risk of gout. Alcohol consumption, especially of beer, also increases the risk of gout.
• Obesity. If you are overweight, your body produces more uric acid and your kidneys have a more difficult time eliminating uric acid, which greatly increases your risk of gout.
• Medical conditions. Certain diseases and conditions make it more likely that you'll develop gout. These include untreated high blood pressure and chronic conditions such as diabetes, metabolic syndrome, and heart and kidney diseases.
• Certain medications. The use of thiazide diuretics — commonly used to treat hypertension — and low-dose aspirin also can increase uric acid levels. So can the use of anti-rejection drugs prescribed for people who have undergone an organ transplant.
• Family history of gout. If other members of your family have had gout, you're more likely to develop the disease.

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