GOUT is a term describing a heterogeneous group of diseases that, in full development, are manifested by (1) an increase in the serum urate concentration, (2) recurrent attacks of a characteristic type of acute arthritis in which crystals of monosodium urate monohydrate are demonstrable in leukocytes of synovial fluid, (3) aggregate deposits of monosodium urate monohydrate (tophi) occurring chiefly in and around the joints of the extremities and sometimes leading to severe crippling and deformity, (4) renal disease of uncertain cause that involves glomeruli, tubules, interstitial tissues, and blood vessels, and (5) uric acid urolithiasis.1 These manifestations may occur in different combinations.
The objective of treatment is to terminate an acute attack rapidly as well as to prevent future attacks of gout, to lower the serum urate concentration to prevent its accumulation in body tissues, to prevent the formation of uric acid calculi, and to treat disorders accompanying hyperuricemia, eg,