Publications by authors named "Dianne Berendsen"
Article Synopsis
- Existing gout classification criteria are outdated and lack sensitivity and specificity, prompting the development of new guidelines.
- An international group reviewed literature, performed diagnostic studies, and analyzed data to create and test these new criteria, focusing on the presence of MSU crystals as a key indicator.
- The new criteria require at least one symptom of joint swelling or pain and demonstrate high sensitivity (92%) and specificity (89%), effectively incorporating modern imaging techniques and evidence.
Objective: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout.
Methods: An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multicriterion decision analysis exercise.
Monosodium urate (MSU) monohydrate crystals synergize with various toll-like receptor (TLR) ligands to induce interleukin-(IL)-1β production. Data are shown from a young male with mitochondriopathy in Kearns-Sayre syndrome (KSS) who developed gout and underwent urate-lowering therapy (ULT) versus a group of common gout patients. Peripheral blood mononuclear cells (PBMCs) are exposed in vitro to MSU crystals in the presence/absence of TLR2 ligands palmitic acid (C16:0) or palmitoyl-3-cysteine (Pam3Cys); proinflammatory cytokine production (IL-1β, IL-6, IL-8) is assessed by specific ELISA's.
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