Tophaceous gout in the elderly: a clinical case review

Abstract

Gout is the most common cause of arthritis in the elderly. Its incidence among older people has risen worldwide due to an increase in risk factors such as renal diseases, metabolic syndrome, and a diet rich in purines. In older age, tophaceous gout may affect different joints from its classical presentation, due to other concomitant musculoskeletal diseases, but specific data on its epidemiology and clinical aspects in the elderly are limited to a few case reports. The present review focuses on the distinctive aspects of tophaceous gout in the elderly, revisiting all our clinical cases seen from 1990 to December 2011. Our findings indicate that: tophaceous gout can affect several joints in the elderly, including some unusual sites; its incidence is similar in both genders in the elderly even if the latency period between its initial diagnosis and the onset of tophi is higher in men; and vertebral localizations are rising and often solitary. The components of metabolic syndrome are the most common medical conditions associated with tophaceous gout. In conclusion, tophaceous gout in the elderly may be a growing medical problem and cause of disability in years, partly because of the new sites involved.

Oxidative stress and antioxidant levels in patients with anorexia nervosa: A systematic review and exploratory meta‐analysis

“…50 Unfortunately, limited research is available regarding to serum uric acid in AN. Serum uric acid could be seen as oxidant marker, being a risk factor for a several metabolic and cardiovascular diseases, [51][52][53] but increasing evidence has shown its importance also as an antioxidant agent, through the free radical scavenging capacity. 54 To the best of our knowledge only one study 32 has compared this marker in AN and in HC subjects, finding that AN subjects could have both lower or higher serum uric acid levels than HCs.…”

Hyperuricemia protects against low bone mineral density, osteoporosis and fractures: a systematic review and meta‐analysis

“…High serum uric acid (SUA) levels seem to be a common risk factor for several metabolic and cardiovascular diseases, namely hypertension, coronary artery disease, diabetes and metabolic syndrome [1][2][3][4]. High SUA levels are also the main risk factor for gout, a condition that is becoming increasingly common among the elderly [5,6].…”

Serum uric acid and incident osteoporotic fractures in old people: The PRO.V.A study

“…Hyperuricemia is significantly 52 associated with obesity, hypertension, dyslipidemia, diabetes and met-53 abolic syndrome, which could increase the risk of developing several 54 conditions, e.g. disability, mortality, osteoporosis and fractures [1][2][3]. 55 Since the risk of monosodium urate (MSU) crystal formation increases 56 linearly with aging, it is hardly surprising that hyperuricemia is a 57 more important risk factor for disability and mortality in older people 58 than in the middle-aged [4].…”