Gota
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![Page 1: Gota](https://reader036.fdocuments.net/reader036/viewer/2022062520/5695cfe01a28ab9b028fef75/html5/thumbnails/1.jpg)
Hiperuricemia y Gota
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Concepto
• Conjunto de manifestaciones, agudas o crónicas, derivadas del depósito de cristales de urato monosódico (MSU) en los tejidos, generalmente articulares, periarticulares y tejido celular subcutáneo
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Epidemiología • Incidencia 1/1000
• Prevalencia 0,8%– 0,03% Nigeria – 15% aborígenes taiwaneses
• 40-50 años
• Hombre>mujer 6:1
• Hiperuricemia (dieta, Fx, genes)
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Etiopatogenia
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Factores de riesgo • Sexo y edad
• Dieta y alcohol
• Fármacos
• Comorbilidades
• Factores genéticos
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Manifestaciones clínicas
• Hiperuricemia asintomática
• Gota aguda
• Período intercrítico
• Gota crónica
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Manifestaciones clínicas• Artritis gotosa aguda
• 40-60 años • 1ª MTF en 85%• Bursitis, tendinitis, tenosinovitis• Virchow + leu, VSG, fiebre• Rx > parte blanda• Fx, dieta, infección
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Manifestaciones clínicas
• Gota intercrítica– 62%– Poliarticular– Menos explosivos– Mayor duración– Daños en Rx– Dx artrocentesis
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Manifestaciones clínicas
• Gota crónica– 11,6 años– Poliarticular– Gota tofácea• EMP• Lesch-Nyhan• ciclosporina
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Condiciones asociadas
• Síndrome metabólico– Obesidad– Hipertrigliceridemia 80%– Diabetes 50%– HTA 38%– Ateroesclerosis
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Condiciones asociadas
• Enfermedad renal– Hombre 13 mg y mujer 10 mg
– Nefropatía por uratos
– Nefropatía por ácido úrico
– Nefropatía familiares• Gotosa juvenil• Enf renal quística medular
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Diagnóstico
• Manifestaciones clínicas
• Valor de la hiperuricemia
• Pruebas de imagen
• Identificación de cristales
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Tratamientos
• Inhibidores de la xantina oxidasa– Alopurinol y febuxostat
• Uricosúricos – Benzobromarona
• Uricasa – Rasburicasa– Pegloticasa
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Tratamientos
• Tratamiento y profilaxis – AINEs (tradicionales y inh COX-2)
– Colchicina
– Corticoides (sistémicos e intraarticulares)
– Inhibidores IL1
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