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.

2. The factors that increase blood uric acid

a) Increased uric acid production

• Increased uric acid congenital created: Due to the abnormal enzyme deficiency or complete enzyme hypoxanthine guanine phosphoribosyltransferase part (HGPRT), or by increasing the activity of enzymes phosphoribosylpyrophosphate (PRPP).

• Increased uric acid generated by increased exogenous purines: Regularly eating foods with purines people (especially red meat such as dogs, cows, goats, seafood ...); drink a lot of alcohol.

• Increased uric acid in creating illness or drug use leads to increased cell death seen in multiple myeloma bone disease, hemolytic anemia, leukemia (leucemie), using chemical cytotoxicity in cancer treatment; Psoriasis ...

b) Reducing uric acid excretion

• Group declining ability to excrete uric acid in renal tubules multiple primary cause, particularly in cases where people eat more foods containing purines, alcoholism. This type often familial, often triggered by drinking too much alcohol. This is the most common group (90% of cases).

• Reducing uric acid excretion by chronic renal failure

• Do blood acidosis, reduce uric acid excretion: ketones acidosis in diabetes.

• Reduce the excretion of uric acid by the use of the drug: It is a common low-dose aspirin; Low doses of phenylbutazone; majority of the prolonged use of diuretics (spironolactone group minus) as thiazides, furosemide; tuberculosis drug as ethambutol, pyrazinamide; the drug ethacrynic acid, nicotinic acid ...