Causes of gout

What causes a gout?

Hi, today we aren’t going to deal with any new study or research finding rather will look into a specific issue of interest to many that is-what causes a gout? Before we immerse ourselves in the causes of gout let’s have few lines briefing about what the disease is about. Gout is a disease condition that affects the joints of our body due to certain crystals (monosodium urate crystals) accumulation. It occurs in association with high blood uric acid level. When uric acid levels are too high than normal uric acid crystals are formed and precipitated in joints.

This crystals when seen under microscope look like needles and in medical literature it’s said to have negatively birefringent pattern (just to know, don’t bang your head with the term ‘negatively birefringence’, it’s all related to lab people who identify those crystals).

Uric acid crystals

Uric acid crystals

The disease can have an acute or a chronic presentation and cause pain in the affected joint. It can present as tophi also. The crystals can form stones in kidney and might contribute in causing a condition called urate nephropathy. Historically gout is known as rich peoples disease or disease of kings.

Hope that was enough of introduction. Now lets look into our discussion topic today that is the what causes gout?

The rule of thumb might be like this to identify causes of gout- anything that raises the blood uric acid level may precipitate a gout (but not always). For example what we call is purine diet like read meat which upon digestion breakdown to uric acid and increase its level. Similarly certain vegetable like beans, peas, lentils etc. Alcohol are also accused as the offender. These were examples of some food and beverages that can cause a gout.

Next in the list of offenders are drugs. Diuretic drugs like loop diuretics (furosemide) and thiazides decrease the excretion of uric acid and increase its level in blood and gout can occur (diuretics are drugs that helps remove our body water through urine (hence named di-uretic). Another set of drugs that can raise uric acid levels and cause gout are the immunosuppressive drugs (don’t want to list them here) . Just to ease your reading – immunosuppressive drugs are used for treating disease related to malfunction of our immune system like in cases after organ transplantation (eg kidney transplantation), rheumatoid arthritis, systemic lupus erythematosus (SLE in short) etc.

English: Gout presenting in the metatarsal-pha...

Gout presenting in a joint of the big toe. Slight redness of the skin on the joint.

Furthermore there are certain diseases where uric acid level in blood can be sky high to cause a gout and one such example is Lesch Nyhan disease (due an enzyme deficiency called HGPRT -hypoxanthine-guanine phosphoribosyltransferase- vigorous attempts to pronounce the enzyme name might save your loose tooth extraction charges- just kidding!). In this disease the affected individual has self mutilating behaviors like biting their own lips and fingers.

Finally as we see in present day medicine the evil of most diseases are our own genes. Blame whom? Partly blame your ancestry as if we are set with a time bomb in our body and at some part of our life the bomb activates and can cause a gout or a breast cancer or an osteoarthritis or a type 2 diabetes. Genetics are partly linked with gout too.

That was a briefing of causes of gout. Some other day in some other post we’ll talk the rest of the disease i.e. its symptoms and treatment. Should go for a coffee now. Tired of typing.

gouty tophi on knee and elbow of middle aged nurse

gouty tophi

Please cross check information from other sources too. For all your health concerns please be guided by your healthcare provider.