Als from the synovial fluid of ZM241385 structure patients with gout were composed
Als from the synovial fluid of patients with gout were composed of monosodium urate. Their classic report described the use of compensated polarized light microscopy to examine joint fluid for crystals, and this technique was subsequently used to identify calcium pyrophosphate dehydrate crystals in synovial fluid from the joints of patients with chondrocalcinosis and `pseudogout’ [19]. It was recognized that gout could be inherited as early as the second century AD by the distinguished Cappadocian physician Aretaeus, who described what he called a gouty `diathesis’ [20]. However, it was to be the 18th century before gout became associated with certain external, and possibly inherited, physical characteristics by the Edinburgh physician William Cullen, who wrote, “The gout attacks men of especially robust and large bodies, men of large heads … and men whose skins are covered with a thick rete mucosum with coarse surface … especially men of a choleric-sanguine type … [whose fathers had suffered]” [5]. In 1771, William Cadogan asked, “If the features of the countenance, the outside of the body, are often hereditary, why not also the inside?’ Despite these observations, it was not until 1931 that Sir Archibald Garrod (the son of Sir Alfred Garrod) suggested that gout be included among disorders that could result from `inborn errors of metabolism” [21], and the first specific purine enzyme deficiency to be associated with a rare type of inherited gout was not described until 1967 [22].From Hippocrates [2].democratic times, gout is becoming less upper-class and is now open to all … It is ridiculous that a man should be barred from enjoying gout because he went to the wrong school.” In earlier times, attacks of gout were also seen as a prophylactic against more serious diseases. According to the writer Horace Walpole [7], gout “prevents other illnesses and prolongs life … could I cure that gout, should not I have a fever, a palsy, or an apoplexy?” In recent decades, however, the diet and lifestyle that predispose individuals to hyperuricemia and gout have become increasingly common. The role of excess dietary purines (derived from meat, seafood, and beer) in the development of gout is illustrated by the disparity between the incidence of gout in Asia and Europe. Traditional Asian diets, based on rice and vegetables, are low in dietary purines, and gout has been relatively rare in these cultures. In contrast, European and American diets, which are high in meat and certain seafoods, are associated with hyperuricemia and gout [8,9]. Increasing affluence has also led to an expansion in the number of people following a westernized diet and lifestyle, and this has been paralleled by an increase in the incidence and prevalence of gout worldwide. Historically, gout has been considered to be primarily a male disease. The fact that women can also develop gout was first recognized during the reign of Nero (AD 54?8) by Seneca, who observed, “in this age, women rival men in every kind of lasciviousness … why need we then be surprised at seeing so many of the female sex afflicted with the gout?” [4]. In the modern era, although gout remains primarily a disease of men in middle PubMed ID:https://www.ncbi.nlm.nih.gov/pubmed/25962748 age, it has become increasingly more frequent in women, particularly after the menopause.Uric acid as a factor in the causation of goutAntoni van Leeuwenhoek (1632?723), one of the pioneers of microscopy, was the first to describe the appearance of the crystals from a gout.
