Reduced Creatinine Clearance and Tophi Development in Gout
Reduced Creatinine Clearance and Tophi Development in Gout
The tophus is the pathognomic feature of chronic gout, and represents a chronic foreign-body granulomatous response to monosodium urate (MSU) crystal deposits. In untreated gout, development of subcutaneous tophi is typically a late feature of disease, occurring more than 10 years after development of gout flares. Tophi are more frequently observed in people with prolonged disease duration, advanced age, diuretic use, corticosteroid use and solid organ transplantation. Gouty tophi have major clinical relevance, as they contribute to musculoskeletal disability and reduced health-related quality of life. These lesions are also implicated in joint damage in gout, and are associated with increased risk of mortality in people with gout.
Although these lesions are typically a late feature of gout, gouty tophi occasionally present early in the course of disease, either as the initial manifestation of gout or within a few years of first gout flare. The factors associated with early presentation of subcutaneous tophi in people with gout have not been reported. The aim of this analysis was to identify factors associated with the presence of early tophaceous disease.
Background
The tophus is the pathognomic feature of chronic gout, and represents a chronic foreign-body granulomatous response to monosodium urate (MSU) crystal deposits. In untreated gout, development of subcutaneous tophi is typically a late feature of disease, occurring more than 10 years after development of gout flares. Tophi are more frequently observed in people with prolonged disease duration, advanced age, diuretic use, corticosteroid use and solid organ transplantation. Gouty tophi have major clinical relevance, as they contribute to musculoskeletal disability and reduced health-related quality of life. These lesions are also implicated in joint damage in gout, and are associated with increased risk of mortality in people with gout.
Although these lesions are typically a late feature of gout, gouty tophi occasionally present early in the course of disease, either as the initial manifestation of gout or within a few years of first gout flare. The factors associated with early presentation of subcutaneous tophi in people with gout have not been reported. The aim of this analysis was to identify factors associated with the presence of early tophaceous disease.
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