Author/Editor		Holc, Iztok; Pahor, Artur
Title		Urični artritis - novosti v zdravljenju
Translated title		Gouty arthritis - novelities in treatment
Type		članek
Source		In: Hojs R, editor. Zbornik prispevkov 20. srečanje internistov in zdravnikov družinske medicine "Iz prakse za prakso" ; 2009 maj 8-9; Maribor. Maribor: Univerzitetni klinični center,
Publication year		2009
Volume		str. 159-66
Language		slo
Abstract		Gout (monosodium urate crystal deposition disease) is characterizied biochemically by extracellular urate supersaturation. The clinical manifestations include: recurrent attacks of acute inflammatory arthritis, accumulation of urate crystals in the form of tophaceus deposits, uric acid nephrolithiasis, a chronic nephropathy that in gouty patients is most often due to comorbid state. All patients with gout have hyperuricaemia at some point in their disease. However, most hiperuremic individuals never experience a clinical event resulting from urate crystal deposition. Thus, the diagnosis of gout focuses on the fundamental pathophysiologic events defining the clinical state: tissue deposition of urate crystals; and the accompanying inflammatory and degenerative consequences. Within this framework, hyperuricaemia is viewed as a necessary but not sufficient precondition for the development of urate crystal deposition disease, and is to be distinguished from gout, the clinical syndrome. The clinical manifestations, diagnosis of gout, asymptomatic hyperuricaemia, the treatment of acute gout, and prevention of recurrent gout will be reviewed.
Summary		Protin (bolezen odlaganja uratnih kristalov) je bolezen, ki biokemično označuje zunajcelično prekomerno zasičenje s sečno kislino. Poznamo različne klinične slike: ponavljajoči se napadi akutnega vnetnega artritisa, odlaganje uratnih kristalov v obliki tofov, uratni ledvični kamni in kronična bolezen ledvic pri bolnikih s protinom. Vsi bolniki s protinom imajo hiperurikemijo v nekem obdobju svoje bolezni. Vendar se pri večini bolnikov s hiperurikemijo nikoli ne pojavijo klinični znaki, ki so posledica odlaganja uratnih kristalov. Diagnoza protina sloni na tipičnih kliničnih znakih, ki so posledica sprememb v sintezi purinov: klinična slika je odraz odlaganja uratnih kristalov v tkivih in posledičnih vnetnih in degenerativnih sprememb. Iz tega sledi, da je hiperurikemija potreben, a ne zadosten predpogoj za nastanek bolezni nalaganja uratnih kristalov in jo je treba ločiti od protina, ki je klinični sindrom. Razpravljali bomo o zdravljenju akutnega artritisa ter preprečevanju akutnega artritisa ter preprečevanju ponavljajočih se zagonov artritisa.
Descriptors		GOUT GOUT ARTHRITIS, GOUTY ANTI-INFLAMMATORY AGENTS, NON-STEROIDAL GOUT SUPPRESSANTS COLCHICINE