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Gout: HELP
Articles from Beth Israel Deaconess
Based on 4 articles published since 2008

These are the 4 published articles about Gout that originated from Beth Israel Deaconess during 2008-2019.
+ Citations + Abstracts
1 Guideline Autosomal dominant tubulointerstitial kidney disease: diagnosis, classification, and management--A KDIGO consensus report. 2015

Eckardt, Kai-Uwe / Alper, Seth L / Antignac, Corinne / Bleyer, Anthony J / Chauveau, Dominique / Dahan, Karin / Deltas, Constantinos / Hosking, Andrew / Kmoch, Stanislav / Rampoldi, Luca / Wiesener, Michael / Wolf, Matthias T / Devuyst, Olivier / Anonymous4640822. ·Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. · Divisions of Nephrology and Molecular and Vascular Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. · INSERM U1163, Laboratory of Hereditary Kidney Diseases, Paris, France. · Paris Descartes University, Imagine Institute, Paris, France. · Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. · Département de Néphrologie et Transplantation d'organes, CHU Rangueil, Toulouse, France. · Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Gosselies, Belgium. · Department of Biological Sciences, Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus. · UKD Foundation, New York, New York, USA. · Institute for Inherited Metabolic Disorders, Charles University in Prague, Prague, Czech Republic. · Molecular Genetics of Renal Disorders Unit, Division of Genetics and Cell Biology, Dulbecco Telethon Institute c/o IRCCS San Raffaele Scientific Institute, Milan, Italy. · Division of Pediatric Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. · Institute of Physiology, University of Zurich, Zurich, Switzerland. ·Kidney Int · Pubmed #25738250.

ABSTRACT: Rare autosomal dominant tubulointerstitial kidney disease is caused by mutations in the genes encoding uromodulin (UMOD), hepatocyte nuclear factor-1β (HNF1B), renin (REN), and mucin-1 (MUC1). Multiple names have been proposed for these disorders, including 'Medullary Cystic Kidney Disease (MCKD) type 2', 'Familial Juvenile Hyperuricemic Nephropathy (FJHN)', or 'Uromodulin-Associated Kidney Disease (UAKD)' for UMOD-related diseases and 'MCKD type 1' for the disease caused by MUC1 mutations. The multiplicity of these terms, and the fact that cysts are not pathognomonic, creates confusion. Kidney Disease: Improving Global Outcomes (KDIGO) proposes adoption of a new terminology for this group of diseases using the term 'Autosomal Dominant Tubulointerstitial Kidney Disease' (ADTKD) appended by a gene-based subclassification, and suggests diagnostic criteria. Implementation of these recommendations is anticipated to facilitate recognition and characterization of these monogenic diseases. A better understanding of these rare disorders may be relevant for the tubulointerstitial fibrosis component in many forms of chronic kidney disease.

2 Editorial Editorial: The Ethics of Recent Gout Trials. 2016

Shmerling, Robert H. ·Beth Israel Deaconess Medical Center, Boston, Massachusetts; Chair, American College of Rheumatology Committee on Ethics and Conflicts of Interest. ·Arthritis Rheumatol · Pubmed #27110864.

ABSTRACT: -- No abstract --

3 Review Treatment of tophaceous gout: When medication is not enough. 2016

Kasper, Isaac R / Juriga, Matthew D / Giurini, John M / Shmerling, Robert H. ·Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Electronic address: ikasper@bidmc.harvard.edu. · Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA. · Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. ·Semin Arthritis Rheum · Pubmed #26947439.

ABSTRACT: OBJECTIVES: To review the literature concerning surgical intervention of tophaeceous gout and propose clinical circumstances for when it may be considered. INTRODUCTION: Tophi develop in approximately 12-35% of patients with gout. Tophaceous disease is usually preventable given the availability of effective urate lowering therapies (ULT) including allopurinol, febuxostat, probenecid, lesinurad, and pegloticase. Despite medical therapy, there remains a subset of patients who develop significant complications of tophi including infection, ulceration, and entrapment neuropathy. Tophi in close proximity to joints can cause joint instability, severely limited range of motion, and significant functional impairment. For the rare circumstance when a tophus is causing an urgent complication or if a patient has a contraindication to all available ULTs, surgery may be an appropriate option. This review summarizes the published experience with surgical interventions for tophaceous gout and offers recommendations for its consideration. METHODS: Using Medline and Google Scholar, all available series of surgery for tophaceous gout were reviewed. RESULTS: Overall, 7 published surgical series were identified. In all, 6 of these 7 series were published between 2002 and 2014. The reported outcomes of surgical interventions for tophaceous gout were generally positive without major post-surgical complications. CONCLUSION: Although medical therapy with ULTs should be the first-line approach to tophaceous gout, surgery should be considered for the rare patient with impending or severe, debilitating complications including infections, entrapment neuropathy or those at risk for permanent joint destruction. In these selected clinical circumstances, surgical intervention for tophaceous gout may be appropriate.

4 Clinical Conference Management of gout: a 57-year-old man with a history of podagra, hyperuricemia, and mild renal insufficiency. 2012

Shmerling, Robert H. ·Division of Rheumatology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA. rshmerli@bidmc.harvard.edu ·JAMA · Pubmed #23188030.

ABSTRACT: Gout is an ancient disease. Despite significant advances in the understanding of its risk factors, etiology, pathogenesis, prevention, and treatment, millions of people with gout experience repeated attacks of acute arthritis and other complications. The incidence of gout is increasing, most likely reflecting increasing rates of obesity and other lifestyle factors, including diet. Comorbid conditions that often accompany gout, including chronic kidney disease and diabetes mellitus, present challenges for the management of gout. Using the case of Mr R, a 57-year-old man with a history of podagra, hyperuricemia, and mild renal insufficiency, the diagnosis and treatment of gout are discussed. For those with moderate to severe gout, urate-lowering treatment can eliminate acute attacks of arthritis and prevent complications. In the near future, it is likely that new risk factors for gout will be identified and new ways of preventing and managing this common disease will become available.