Tophus Health Dictionary

A term used to describe several disorders associated with a raised concentration of URIC ACID in the blood, of which various forms of in?ammatory disease and kidney disease are the most important. The condition has an overall prevalence in the UK of around 0·6 per cent.

Causes The cardinal feature of gout is the presence of an excessive amount of uric acid in PLASMA and various body tissues, and its deposition in the joints in the form of sodium monourate. The cause of this excess is not known, but there is an hereditary element and there is a family history of the disease in 50–80 per cent of cases. Inadequate exercise, habitual over-indulgence in animal food and rich dishes, and excess of alcohol have been indicated as precipitating factors, but the disease can occur in vegetarians and teetotallers.

Gout is infrequent before the age of 40, but it may occasionally affect very young people in whom there is a strong family history. About 95 per cent of patients are males. In women it most often appears during the menopause.

Symptoms An attack of gout may appear without warning, or there may be premonitory symptoms. The affected joint is swollen and the symptoms come and go, usually being worse at night. Tophi (see TOPHUS) may develop around an affected joint. Urinary CALCULI (uratebased) often occur in patients with gout.

Treatment and prevention NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) such as NAPROXEN should be started as soon as possible for an acute attack. After the attack subsides, a lower dose should be continued for at least a week. Salicylates (such as aspirin) and diuretics should be avoided.

In patients prone to recurrent or particularly severe attacks, long-term prophylaxis with ALLOPURINOL is indicated, especially when associated with kidney disease. This drug, which has few side-effects, lowers the serum urate concentration by preventing the formation of uric acid. A sensible weight-reducing diet is usually helpful.... gout

Growth of excessive hair, often in places that are not normally hairy. Hypertrichosis often occurs as a result of taking certain drugs (including ciclosporin and minoxidil). The term hypertrichosis is also used to describe hair growth in a mole. Hypertrichosis isnot the same as hirsutism, which is due to abnormal levels of male hormones. hypertrophy Enlargement of an organ or tissue due to an increase in the size, rather than number, of its constituent cells. For example, skeletal muscles enlarge in response to increased physical demands. (See also hyperplasia..

hyperuricaemia An abnormally high level of uric acid in the blood. Hyperuricaemia may lead to gout due to the deposition of uric acid crystals in the joints; it may also cause kidney stones (see calculus, urinary tract) and tophus.

Hyperuricaemia may be caused by an inborn error of metabolism (see metabolism, inborn errors of), by the rapid destruction of cells in a disease such as leukaemia, or by medication that reduces the excretion of uric acid by the kidneys, such as diuretic drugs. Large amounts of purine in the diet may also cause hyperuricaemia.

Drugs such as allopurinol or sulfinpyrazone are prescribed for the duration of the patient’s life. Purine-rich foods should be avoided.... hypertrichosis