Gout and Organ Transplantation.
Summary of "Gout and Organ Transplantation."
Acute and chronic gout are common complications following organ transplantation. Risk factors include those shared with the general population (eg, diuretic use) and transplant-specific risk factors (eg, cyclosporine). Clinical features of gout are similar to those seen in the general population, although tophi may be more common. A definitive diagnosis requires demonstration of monosodium urate crystals within synovial fluid or tophi. Treatment is often empiric, although a poor response should prompt joint aspiration to exclude septic arthritis. Corticosteroids are commonly used to treat acute gout due to the adverse profile and drug interactions with NSAIDs and colchicine. Sustained reduction of serum urate (≤6 mg/dL) is critical in long-term management. Allopurinol is the most commonly used agent, although vigilant monitoring is required if combined with azathioprine. Other options include febuxostat and benzbromarone. The role of newer agents such as interleukin-1 inhibitors and uricases remains to be determined. General measures should include minimizing diuretic use.
Affiliation
Department of Medicine, University of Otago, Christchurch, P.O. Box 4345, Christchurch, 8140, New Zealand, lisa.stamp@cdhb.govt.nz.
Journal Details
This article was published in the following journal.
Name: Current rheumatology reports
ISSN: 1534-6307
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22258500
- DOI: http://dx.doi.org/10.1007/s11926-012-0235-9
Medical and Biotech [MESH] Definitions
Tissue And Organ Procurement
The administrative procedures involved with acquiring TISSUES or organs for TRANSPLANTATION through various programs, systems, or organizations. These procedures include obtaining consent from TISSUE DONORS and arranging for transportation of donated tissues and organs, after TISSUE HARVESTING, to HOSPITALS for processing and transplantation.
Tissue And Organ Harvesting
The procedure of removing TISSUES, organs, or specimens from DONORS for reuse, such as TRANSPLANTATION.
Cold Ischemia
The chilling of a tissue or organ during decreased BLOOD perfusion or in the absence of blood supply. Cold ischemia time during ORGAN TRANSPLANTATION begins when the organ is cooled with a cold perfusion solution after ORGAN PROCUREMENT surgery, and ends after the tissue reaches physiological temperature during implantation procedures. WARM ISCHEMIA TIME starts then and ends with completion of SURGICAL ANASTOMOSIS.
Transplantation Conditioning
Preparative treatment of transplant recipient with various conditioning regimens including radiation, immune sera, chemotherapy, and/or immunosuppressive agents, prior to transplantation. Transplantation conditioning is very common before bone marrow transplantation.
Organ Transplantation
Transference of an organ between individuals of the same species or between individuals of different species.
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