gout [L, gutta, drop] , a disease associated with an inborn error of uric acid metabolism that increases production or interferes with excretion of uric acid. Excess uric acid is converted to sodium urate crystals that precipitate from the blood and become deposited in joints and other tissues. Men are more often affected than premenopausal women. The great toe is a common site for the accumulation of urate crystals. The condition can cause exceedingly painful swelling of a joint, accompanied by chills and fever. The symptoms are recurrent. Episodes become longer each year. The disorder is disabling and, if untreated, can progress to the development of destructive joint changes, such as tophi. Treatment usually includes administration of colchicine, phenylbutazone, indomethacin, or glucocorticoid drugs and a diet that excludes purine-rich foods such as organ meats. It may include surgical removal of ulcerated tophi. Chronically, probenecid, allopurinol, or colchicine may be used to decrease uric acid levels. Acquired gout is a condition having the signs and symptoms of gout but resulting from another disorder or treatment for a different condition. Diuretic drugs can alter the concentration of uric acid so that uric acid salts precipitate from the blood and are carried to the joints. See also chondrocalcinosis, Lesch-Nyhan syndrome, tophus.
