Characteristics of gouty arthritis in the guatemalan population Originals Received: 23 January 1995 Accepted: 04 August 1996 DOI:
Cite this article as: Garcia, C.O., Kutzbach, A.G. & Espinoza, L.R. Clin Rheumatol (1997) 16: 45. doi:10.1007/BF02238762 Summary
The purpose of this study was to determine the characteristics of gouty arthritis in an urban Guatemalan population. We reviewed the medical records of 148 (145 males and 3 females) patients with a diagnosis of acute gouty attack seen at an urban rheumatology clinic in Guatemala City between 1982 and 1993. Mean age at diagnosis was 49 years (range 21–87), mean age of onset was 42 years, mean duration of disease 7.4 years, family history of gout 42 (28%), peak prevalence 5
th decade 39 (26%). Seventy-one (48%) had monarticular, 49 (33%) oligoarticular, and 22 (15%) polyarticular attacks, respectively. Podagra was seen in 34 (23%) patients; however, 108 (73%) developed it at any moment of their life. Tophaceous gout was seen in 33 (22%). Mean serum urate concentrations (enzymatic method) were higher than 7.0 mg % in 90 (60%) patients. At follow-up, 44 (30%) patients never returned to our clinic, and a large majority of them [66 (45%)] were seen only during acute attacks. Associated disorders included hypertension (43%), obesity (27%), nephrolithiasis (16%), ischaemic heart disease (7%), renal insufficiency (2%), stroke (0.6%), and diabetes mellitus (0.6%), and two died due to sepsis; high alcoholic intake was found in 58 (39%) patients. In conclusion, our findings indicate that gout is not an unusual disorder in the Guatemalan population. It presents with the same characteristics as those reported in Caucasians, with the possible exception of a lower frequency of diabetes mellitus as an associated disorder. Key words Gouty Arthritis Uric Acid Guatemalan Population References
Talbott JH, Yu TF. Gout and uric acid metabolism. Stration Intercontinental Medical Book Corp. 1976: 1–25.
Roubenoff R. Gout and hyperuricemia. In: Epidemiology of Rheumatic Diseases. Rheum Dis Clin North Am 1990; 16: 539–50.
Rose BS, Prior IAM, Davidson F. Gout and hyperuricemia in New Zealand and Polynesia. In: Population Studies of the Rheumatic Diseases. Eds.: Bennett, P.H., Wood, P.H.N. Amsterdam/New York: Excepta Medica 1968: 344–9.
Rose BS. Gout in the Maoris. Semin Arthritis Rheum 1975; 2: 121–45.
Darmawan J, Valkenburg HA, Muirden K, Wigley RD. The epidemiology of gout and hyperuricemia in a rural population of Java. J Rheumatol 1992; 19: 1595–99.
Hall AP, Barry PE, Dawboy TR, McNamara PM. Epidemiology of gout and hyperuricemia. Am J Med 1967; 42: 27–37.
Kellgren JH, Lawrence JS, Aitken-Swan J. Rheumatic complaints in an urban population. Ann Rheum Dis 1953; 12: 5–15.
Proper AJ, Hewit JV. Gout and hyperuricemia in rural and urban populations. Ann Rheum Dis 1962; 21: 154–67.
Fernandez del Vallado P, Jimenez C, Gijon J, Rapado A. La goutte fémenine. In: Seze S, ed. Travaux de Congrés International de la Goutte et de la Lithiase Urique. Evian, France: Presses du Val D'Osne: 1964: 75–84.
Grahame R, Scoot JT. Clinical survey of 354 patients with gout. Ann Rheum Dis 1970; 29: 461–8.
Lou SF, Yu KH, Jan WU YJ, Ho HH. Clinical features of gout in 822 Chinese patients. Rev Esp Reum 1993; 20 We44 (suppl 1).
Pilipovic N. Clinical manifestations in 530 gout patients. Rev Esp Reum 1993; 20 We55 (suppl 1).
Nishioka N, Mikanag K. Clinical features of 4000 gouty subjects in Japan. In: Purine Metabolism in Man. Eds.: Rapado A, Watts RWE, De Bruyn CHMM. 3rd ed., New York, Plenum Press, 1980; 47–54.
Hadler NM, Frank WA, Bress NM, Robinson DR. Acute polyarticular gout. Am J Med 1974; 56: 715–9.
National Center for Health Statistics: Dawson DA, Adams PF. Current estimates from National Health Interview Survey, United States, 1986 Vital and Health Statistics, Series 10, No. 164 DHHS Pub No. (PHS)87-1592 Washington DC, US Gout. Printing Office, 1987.
Wallace SL, Robinson H, Masi AT, Decker JL, MaCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum 1977; 20: 895–900.
1988 Joint National Committee. The 1988 report of the Joint National Committee on Detection, Evolution and Treatment of High Blood Pressure. Arch Intern Med 1988; 148: 1023–38.
National Diabetes Group. Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes 1979; 28: 1039–51.
Black D, James WPT, Besser GM, et al. Obesity. A report of the Royal College of Physicians. J R Coll Physicians Lond 1983; 17: 5–65.
Nakayama DA, Barthelemy C, Carrera G, Lightfoot Jr, RW Wortmann RL. Tophaceous gout: A clinical and radiographic assessment. Arthritis Rheum 1984; 27: 468–72.
Dunn JP, Brooks GW, Mausner J, Rodnan GP. Social class gradient of serum uric acid levels in males. JAMA 1963; 185(3): 93–98.
Cobb S, Dunn JP, Brooks GW, Rodnan GP. Serum urate levels in males by social class. Arthritis Rheum 1961; 4: 412.
Lawrence RC, Hockborg MC, Kelsey JL, McDuffie FC, Medsger Jr TA, Felts WE, Shulman LE. Estimates of the prevalence of selected arthritis and musculoskeletal diseases in the United States. J Rheumatol 1989; 16: 427–41.
Mizraji M, Crespo DI. Chronic tophaceous gout of 51 years of duration. El Dia Medico Uruguayo 1955; 22: 635–40.
Moreno AR. Incidence of gout in Buenos Aires. Semin Hop Paris 1952; 28: 2369–75.
Lackington C. Incidencia relativa de las afecciones reumaticas. Analisis de 1,442 casos. Rev Med Chil 1972; 100: 564–71.
Mituszova M, Judat A, Poor G, Gyodi E, Stenszky V. Clinical and family studies in Hungarian patients with gout. Rheumatol Int 1992; 12: 165–8.
Alarcón-Segovia D, Ramos Miembro F, Gonzalez Amarro RF. One thousand private rheumatology patients in Mexico City. Arthritis Rheum 1983; 26: 688–89.
Cassim B, Mody GM, Deenadayalu VK, Hammond MG. Gout in black South Africans: a clinical and genetic study. Ann Rheum Dis 1994; 53: 759–62.
Yu TF. Some unusual features of gouty arthritis in females. Semin Arthritis Rheum 1977; 6: 247–55.
Turner RE, Frank MJ, Van Ausdal D, Bollet AJ. Some aspects of the epidemiology of gout: Sex and race incidence. Arch Int Med 1960; 106: 400–404.
Meyer OL, Monteagudo FSE. Gout in females: an analysis of 92 patients. Clin Exp Rheum 1985; 3: 105–9.
Levinson DJ, Becker MA. Clinical gout and the pathogenesis of hyperuricemia. In: Arthritis and Allied Conditions. Eds.: McCarty DJ, Koopman WJ. 12th ed. Lea & Febiger 1993; 2: 1773–1807.
Puig JG, Michan AD, Jimenez ML, Perez de Ayala C, Mateos FA, Capitan CF, Miguel E, Gijon JB. Female gout. Clinical spectrum and uric acid metabolism. Arch Int Med 1991; 151: 726–32.
Lally EW, Ho Jr G, Kaplan SR. The clinical spectrum of gouty arthritis in women. Arch Int Med 1986; 146: 2221–25.
Bosmansky K, Kovalancik M, Rovensky J, Pullman R. Analysis of clinical and biochemical finding in 371 patients with gout. Rev Esp Reum 1993; 20: We64 (suppl 1).
Frohlich ED. Uric acid. A risk factor for coronary heart disease. JAMA 1993; 270(3): 378–9.
Brand FN, Mcgee DL, Kanel WB, Stokes J, Castelli WP. Hyperuricemia as a risk factor of coronary heart disease. Am J Epidemiol 1985; 121: 11–8.
Weiss TE, Segaloff A, Moore C. Gout and diabetes. Metabolism 1957; 6: 103–6.
Gutman AB. Gout. In: Textbook of Medicine. 12th ed. Eds.: PB Beeson, W McDermontt. Philadelphia, WB Saunders Company 1967, pp 1238–48.
García CO, García-Kutzbach A, Espinoza LR. Gout in the Americas. Rev Bras Reum 1995; 35: 1–2.
Macfarlane DG, Dieppe PA. Diuretic-induced gout in elderly women. Br J Rheumatol 1985; 24: 155–7.
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