痛風症の臨床的観察

Thirteen cases of gout encountered between April 1961 and December 1965 in the clinic of Branch Hospital of Okayama University at Misasa Spa are described and the brief outline of the treatment of gout is suggested. Clinical findings: 1) All of thirteen cases were male. 2) The presumptive onset of the disease showed the highest incidence at the fifth decade. 3) The period between the onset of gouty attack and the diagnosis of gout ranged from four months to twenty-seven years. 4) The first attack was experienced on the first metatarsophalangeal joint in six cases. 5) The gouty tophi in six and the urate crystals in seven cases were observed. Laboratory findings: 1) The high blood uric acid level was observed in all cases. 2) Seven of nine procedured had anemia with color index of normochrome in five, hyperchrome in two and hypochrome in one. 3) The white blood corpuscles remained within normal limit except of two cases of mild leucopenia. 4) Abnormal results of the liver function test were observed in BSP, C.C.F., TAKATA'S reaction and the serum transaminases (SGOT, SGPT). The normal serum protein was detected. 5) None of cases showed the positive RA test. CRP remained normal in the intermittent phase. Diagnosis: The differential diagnosis between gouty arthritis and rheumatoid arthritis was emphasized. Complications: 1) Renal calculi were recognized roentgenologically in two cases, who had experienced attacks of renal colic. 2) Renal function test showed abnormality in PSP excretion and urine concentration. Blood urea nitrogen increased above the normal limit in seven cases. The decreased urea clearance in two and decreased uric acid clearance in one of them were observed 3) Hypertention was seen in seven cases but all except one recovered normal values with treatment of gout plus hypertention.

原著論文 (Original Paper)