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Is lactic acid a misunderstood trigger of gout attack for a century?
Colloids Surf B Biointerfaces
June 2024
School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210046, China.
A gout attack could be viewed as a nucleation event. Many reports have shown that the typical molecular structure of crystallization inhibitors usually contains carboxyl and hydroxyl groups, which could interact with solute molecules through hydrogen bonding, thereby suppressing the nucleation and growth of crystals. Since 1923, l-lactic acid (LA), a molecule with structural features of inhibitors, has been speculated to be a trigger for acute gout because metabolized LA temporarily reduces uric acid excretion and leads to a slow increase in serum uric acid concentration.
View Article and Find Full Text PDFMiliarial-type gout in association with chronic use of glucocorticoids.
Rheumatol Int
March 2024
Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico.
Article Synopsis
- * Despite his serum uric acid levels being managed, he developed new intradermal tophi, described as "miliarial-type gout," leading to surgery for his olecranon bursa due to functional limitations.
- * The case highlights persistent tophi formation despite treatment, the potential relationship between glucocorticoid use and gout symptoms, and the coexistence of urate and cholesterol crystals in olecranon bursitis, along with a novel sonographic view of the condition
Uricase-Deficient Larval Zebrafish with Elevated Urate Levels Demonstrate Suppressed Acute Inflammatory Response to Monosodium Urate Crystals and Prolonged Crystal Persistence.
Genes (Basel)
November 2022
Department of Molecular Medicine and Pathology, Faculty of Medical and Health Sciences, University of Auckland, Auckland 1023, New Zealand.
Gout is caused by elevated serum urate leading to the deposition of monosodium urate (MSU) crystals that can trigger episodes of acute inflammation. Humans are sensitive to developing gout because they lack a functional urate-metabolizing enzyme called uricase/urate oxidase (encoded by the gene). A hallmark of long-standing disease is tophaceous gout, characterized by the formation of tissue-damaging granuloma-like structures ('tophi') composed of densely packed MSU crystals and immune cells.
View Article and Find Full Text PDFLong-Standing Gouty Panniculitis.
Actas Dermosifiliogr
June 2023
Servicio de Dermatología, Hospital Universitario San Cecilio, Instituto de Investigación Sanitaria (IBS) Granada, Granada, España. Electronic address:
Septic Arthritis With Superimposed Acute Gouty Arthritis in a Rheumatoid Arthritis Patient.
Cureus
April 2022
Internal Medicine Residency, Aventura Hospital and Medical Center, Aventura, USA.
Septic arthritis is a rare but serious complication of both rheumatoid and gouty arthritis and can lead to significant morbidity and even mortality. Here, we report a case of septic arthritis with bacteremia, monosodium urate crystals, and hyperuricemia in a 75-year-old male with long-standing rheumatoid arthritis. Arthrocentesis revealed gram-positive cocci representing group B streptococcus () infection and monosodium urate crystals.
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