Gout is also known as a disease of affluence, as the onset of the disease is promoted by factors such as obesity, unhealthy diet and lack of exercise. However, the cause of gout is usually a congenital metabolic defect. Typical symptoms of the disease are painful, reddened and swollen joints. The joint of the big toe is particularly frequently affected. Gout can usually be treated well with early and long-term therapy. A chronic course therefore occurs only rarely.
Causes of gout
Gout (hyperuricemia) is a metabolic disease in which too much uric acid accumulates in the blood. In other words, more uric acid is formed than is excreted. An elevated uric acid level often does not cause any symptoms at the beginning. Only when the uric acid level continues to rise over time can an attack of gout occur.
Gout primarily affects men: Over 80 percent of gout patients are male. They usually develop the disease between the ages of 40 and 60. Women usually only develop gout after menopause, if at all.
The disease generally occurs much more frequently in industrialized nations than in developing countries. This is mainly due to differences in diet. This is because purine-rich foods such as meat, offal and alcohol can promote the development of the disease.
Primary gout
In gout, a distinction is made between a primary and a secondary form. The primary form is a congenital metabolic defect that is triggered by the kidney excreting too little uric acid.
In rare cases, it can also occur that too much uric acid is produced due to a genetic defect. This phenomenon, which occurs primarily in boys, is known as Lesch-Nyhan syndrome. Both forms have in common that more uric acid is produced than released. As a result, more and more uric acid accumulates in the body.
Secondary gout
In the secondary form of gout, the hyperuremia is not congenital but is caused by other diseases or disorders. These either cause increased uric acid production or inhibit its release.
If the release is inhibited, a kidney disease such as renal insufficiency is often the cause. Increased production, on the other hand, is usually caused by increased decay of the body’s own cells. This is the case, for example, in leukemia.
Uric acid and purines
Uric acid forms in the body when purines are broken down. On the one hand, this can be the body’s own purines, which are formed during the breakdown of body cells. On the other hand, purines are also found in certain foods, including meat and sausage.
Thus, in summary, the following causes are possible for an elevated uric acid level:
- Too much uric acid is formed in the body.
- Too little uric acid is excreted via the kidneys.
- Too many purines are absorbed through the diet
In most gout patients, there is a congenital tendency to elevated uric acid levels. However, certain behaviors such as a diet high in purines can promote disease. They can often even trigger an acute attack of gout: This is because it is not uncommon for the symptoms to occur after a sumptuous meal and copious alcohol consumption.
