Gout treatment steroid dose

Hyperuricemia is a classic feature of gout, but nearly half of the time gout occurs without hyperuricemia and most people with raised uric acid levels never develop gout. [8] [37] Thus, the diagnostic utility of measuring uric acid levels is limited. [8] Hyperuricemia is defined as a plasma urate level greater than 420 μmol/l ( mg/dl) in males and 360 μmol/l ( mg/dl) in females. [38] Other blood tests commonly performed are white blood cell count , electrolytes , kidney function and erythrocyte sedimentation rate (ESR). However, both the white blood cells and ESR may be elevated due to gout in the absence of infection. [39] [40] A white blood cell count as high as ×10 9 /l (40,000/mm 3 ) has been documented. [11]

The most important determinant of therapeutic success is not which NSAID is chosen, but rather how soon NSAID therapy is initiated. In more than 90 percent of patients, complete resolution of the attack occurs within five to eight days of initiation of therapy. 18 Unfortunately, the use of NSAIDs is limited by side effects. NSAID therapy should be avoided in patients with peptic ulcer disease, low creatinine clearance, liver disease and poorly compensated congestive heart failure, and in patients receiving anticoagulation therapy. 19 , 20 Side effects of NSAIDs are also more pronounced in elderly patients. 21

Polycythemia (elevated red blood cell count) is a rare blood disease in which the body produces too many red blood cells. Causes of polycythemia are either primary (acquired or genetic mutations) or secondary (diseases, conditions, high altitude). Examples of primary polycythemia include:

  • Fatigue
  • Excessive sweating
  • Unintended weight loss
  • Gouty arthritis, usually in big toe
  • Shortness of breath
  • Headaches
  • Dizziness
  • Weakness
  • Feeling pressure or fullness on the left side of the abdomen where the spleen is located.
  • Vision problems
  • Heavy bleeding from minor cuts
  • Bleeding from the gums
  • Itching
  • Redness in the face
  • A burning feeling in the hands and feet

Complications of a high red blood cell count include blood clots, heart attack, stroke, enlarged liver and spleen, angina (heart pain), AML leukemia, and heart failure. Blood clots in the liver or kidney can cause sudden, intense pain. Treatment goals for patients with polycythemia are to manage symptoms and reduce the risk of complications like heart attack and stroke.

REFERENCE: NIH. National Heart, Lung, and Blood Institute. "What Causes Polycythemia Vera"? Updated: Mar 20, 2011.

Gout treatment steroid dose

gout treatment steroid dose

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