32 years old, gout four years ago, tophi formed in many places around his body, miserable , why did his condition progress so quickly?
Mr. Yang has suffered from gout for four years . As time goes by, many large bumps have grown on his finger joints, elbow joints and insteps, which has seriously affected his quality of life. He uses chopsticks to eat. It's very laborious. There are many big lumps formed in the left elbow joint. It's difficult to straighten it and he can't exert normal force at all. Although the problem on the instep doesn't seem serious, it has made it impossible for him to wear shoes normally. The shoes are a little tight and they feel painful. pain. These big packages of
are tophi !
X-ray examination of his hand showed that many bones had been eroded by tophi, a change similar to moth-eaten , and the function of the entire hand was seriously affected. He is only in his 30s, and he still has a long road ahead in life. Such a complicated condition will have such an impact. As a doctor, I really feel deeply for him.
These tophi are equivalent to a huge urate library, which will continuously release urate into the blood and be eliminated through the kidneys. When too much urate is deposited in the structure of the kidney, especially If it is deposited in the renal interstitium and renal tubules , kidney stones will be formed. As time goes by, it will lead to renal insufficiency or renal failure .
Moreover, these tophi themselves can cause serious damage to the patient's tissue structure. Severe cases of tophi will have tophi deposits in their bone marrow, not to mention tendons and surrounding soft tissues. Over time, these tophi will slow down. It slowly destroys the patient's joint structure, causing dysfunction and causing serious consequences.
Dr. Xie once performed tophi removal surgery on a patient with severe tophi. When he used a surgical instrument similar to a spoon called a spatula to remove dead bones, he gently scraped the bone cortex and destroyed it. , and there are tophi in the bone marrow. These tophi are a bit like white ash soaked in water, like tofu dregs.
Some friends may ask, will all patients develop tophi? Tophi are formed little by little in the chronic phase of gout, which is the remission phase. 0% of gout patients who are not treated regularly will develop tophi within years. Generally, gout is diagnosed during the first
0 period. It appears within 15 to 10 years, which means that tophi will generally occur within 15 to 10 years after gout is diagnosed. Patients with hyperuricemia or gout should not be too anxious, because there are many cases where no visible tophi occur even 20 years after gout was diagnosed.
So why did Mr. Yang develop such a large number of tophi so quickly, just four years after his diagnosis? There is a key point in the above paragraph, that is " does not treat regularly"!
Mr. Yang's first gout attack was 4 years ago. When he was diagnosed, his blood uric acid was already as high as 00＋. You must know that the normal limit and upper limit should not exceed 20. This also explains that Mr. Yang is in Before he was diagnosed with gout, he may have been in a state of hyperuricemia for a long time, but there was no attack of gout. These urate crystals slowly accumulated in his body, and finally found an outbreak point. Gout attacks, and the point of this outbreak is often a heavy drink, an injury or a cold, etc.
According to Mr. Yang's own recollection, the attack occurred after drinking. This is also consistent with our relevant research statistics. The first attack of gout in men is often caused by drinking, accounting for about 5.5%.
Mr. Yang is a person who loves drinking. He is a manual worker and has been drinking since he was 16 years old. He consumes about half a catty of liquor and 2 to 5 bottles of beer every day. To be honest, this amount of drinking is really high. Largely, alcohol intake will increase the formation of uric acid in our body, leading to uric acid excretion disorders. This is the main reason why many people develop abnormal uric acid and even gout, especially among men.
Under normal circumstances, when we suffer from gout once, we will actively seek ways to control uric acid, control our diet, exercise actively, drink more water, and communicate with the doctor based on our specific situation to choose whether to proceed. Medications to lower uric acid.
And Mr. Yang did not take gout seriously at all . In the past 4 years, the number of pain attacks was very frequent. When the attacks occurred, Mr. Yang would take some analgesics and be able to control his drinking a little. When the gout entered the remission period, he would not take it seriously. The symptoms were without any contraindications . As a result, in just 4 years, tophi had formed in many parts of his body.
In fact, the control of gout is not as difficult as everyone imagines, but one thing is very important, that is, the patient needs to actively cooperate. If the patient himself does not take the ultra-high uric acid seriously, then no matter how much the doctor says, I'm afraid it won't help.
Basic operations for reducing uric acid:
● Diet control is the basis. For lowering uric acid, controlling one's diet is a cornerstone. Through proper diet control, uric acid can be reduced by an average of about 60% . This requires us to limit the intake of high-purine diets in our daily lives, especially those like some I believe everyone knows about red meat, seafood, animal offal, etc., so we won’t go into details again, but there are some details that we must pay attention to, that is, the intake of alcohol and beverages must be strictly controlled. Many drinks are rich in , fructose, and corn syrup. When metabolized in the body, this substance can lead to an abnormal increase in uric acid, which is the cause of gout in many young people.
●Drink more water. The main purpose of drinking more water is to excrete excess uric acid in the body through the kidneys. It is recommended to drink about 2000 to 2500 ml of warm water every day. Lemon water is also a good choice, but do not add sugar.
●motion. The exercise here must be emphasized not to be too intense. Exercising with a lot of sweating will lead to an abnormal increase in uric acid. Relatively soothing exercise is enough. The main purpose is to help us control our weight and let the body have a better metabolic state. .
●Drugs to lower uric acid. Lowering uric acid through drugs is a behavior that many people are resistant to. They are afraid of the side effects of drugs on the body, but no one has done this calculation. If you have reached the point where you need drugs to see uric acid, then it means that you There is already a large amount of urate deposits in the body. If it is not controlled, it will cause further damage to the body. The large amount of urate crystals accumulated in the body may cause even greater damage.
So if your blood uric acid exceeds 540 for a long time, and you also have abnormal conditions such as hypertension , coronary heart disease , dyslipidemia , etc., and have attacks more than twice a year, it is recommended that you should undergo medication to lower uric acid.
Through scientific and systematic lowering of uric acid, the amount of medication can be slowly and gradually reduced over time, and finally the purpose of stopping the medication is achieved. This is completely possible. However, if does not take medicine to reduce uric acid and allows it to grow freely and wildly, the damage that may be caused will be very serious, and it may cause the formation of a large number of tophi, which may eventually lead to kidney failure.
Summary
Today’s case is really classic, and it is very common in clinical practice. Many people indulge themselves and give up their resistance to gout. The result is eventually backfired by hyperuricemia and gout. It’s serious. Some have hurt their bodies, and some have even been unable to take care of themselves.
Dr. Xie also mentioned earlier in the article that in fact, if we can recognize the damage caused by gout, if we can actively control blood sugar acid and cooperate with doctors to carry out corresponding treatment, controlling uric acid is not that difficult, but it really needs to be done. The patient's careful cooperation, if just shaves his head and picks one end, may not result in good treatment effect, and may eventually lead to complications.
I am Xie Xinhui who insists on using simple language to explain complex disease knowledge. It is not easy to code. If you agree with my point of view, please give me a follow or like. If you or your family and friends also have a school certificate or It’s gout, a disease in this area. Please forward this article to those who need it. Let us cooperate with each other to resist high uric acid. Thank you!
