Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchici...Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchicine. He was seen in consultation for deforming polyarthritis of the small and large joints, which had been evolving for about 2 years. The acute episode occurred 10 days earlier with the onset of bilateral and symmetrical polyarthritis affecting the large and small joints. The physical examination revealed a peripheral joint syndrome with ulnar gale force deformities of the hands and several buttonhole deformities of the fingers. In addition, there were nodules, some of which were fistulised, giving rise to a chalky slurry. The biology revealed an inflammatory syndrome in addition to rheumatoid factors and ACPA, which were elevated. Biological analysis of the nodular fluid revealed clusters of sodium urate crystals and ultrasound scans of the joints revealed a double-contour appearance in several joints. The diagnosis of RA was made using the 2010 ACR/EULAR criteria. The patient was treated as an outpatient with corticosteroids before being put on methotrexate. It is important to understand that these two conditions can occur at the same time, so it is important to consider them when treating patients with gout or RA.展开更多
Background:Gout is an inflammatory joint disease.Modern pharmacological studies have shown that Zanthoxylum bungeanum(Z.bungeanum)has significant anti-inflammatory and osteoprotective effects.This study is aimed to ex...Background:Gout is an inflammatory joint disease.Modern pharmacological studies have shown that Zanthoxylum bungeanum(Z.bungeanum)has significant anti-inflammatory and osteoprotective effects.This study is aimed to explore the therapeutic effect of Z.bungeanum on gouty arthritis.Methods:Firstly,the compounds in the water extract of Z.bungeanum(WZB)were analyzed by UPLC-QE-Orbitrap-MS/MS.The compounds and disease targets were predicted using SwissTargetPrediction platform and GeneCards database,and the candidate targets were acquired by taking the intersection.Next,the protein interaction network was constructed and the hub genes were screened using String platform and Cytoscape software.Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes analysis of hub genes were performed using Metascape platform.Finally,the disease-pathway-target-drug-component network diagram was constructed to obtain the active components and targets for treating disease,and the affinity between components and targets were predicted by applying Discovery Studio software.In vitro,using an acute gout model of RAW 264.7 macrophages induced by Monosodium Urate to evaluate the anti-inflammatory effect of WZB on Gout.Meanwhile,we established a mice model of hyperuricemia and measured the serum xanthine oxidase(XOD)activity and uric acid(UA)contents.Results:A total of 20 chemical components were identified from WZB,mainly alkaloid components.The network pharmacology results showed that Dihydrobungeanool,Quercetin,Hydroxy-α-sanshool and Hydroxy-ɛ-sanshool were the main active components of WZB against gout.MAPK1,PIK3CA,EGFR and TLR1 proteins were the main targets of WZB in the treatment of gout.Pathways in cancer,PI3K/Akt signaling pathway,Th17 cell differentiation and MAPK signaling pathway were closely related to anti-gout.Molecular docking results have shown that Dihydrobungeanool may be the main active ingredient of WZB for gout treatment,and PIK3CA is the main potential target.The cellular gout model showed that WZB significantly reduced IL-1βand TNF-αinflammatory factor levels and influenced the expression of PI3K protein.In addition,WZB administration effectively reduced UA levels and XOD activity in the serum of mice with hyperuricemia.Conclusion:Our study results suggest that WZB could treat gout by acting on PIK3CA gene target to reduce the level of inflammatory factors,and reduce XOD activity to lower UA levels.展开更多
We’re reporting the case of an arthritis to banal germ occurred in concomitance with an advanced polyarticular of gout. It was about a patient of 59 years with alcoholic and gouty chronicle more than 10 years, but wi...We’re reporting the case of an arthritis to banal germ occurred in concomitance with an advanced polyarticular of gout. It was about a patient of 59 years with alcoholic and gouty chronicle more than 10 years, but without specialized medical follow-up. He has been admitted in hospitalization for a big inflammatory and stiff right knee, letting rising the pus through two cutaneous fistulas in a context of non-febrile change of his peripheral polyarthritis of the big and small articulations. Gout was at distal predominance, bilateral, distorting, tophaceous and active. Inflammatory syndrome was important (ESR = 50 mm in the 1st hour and CRP = 28 mg/l) and uricemia was high, at 84 mg/l. The glycaemia, the hepatic, the viral, renal and serological evaluation (HIV and B, C hepatitis) were normal. The bacteriological analysis of the pus collected after puncture of the knee and cleaning identified a negative gram bacillus, Morganella morganii, multi-resistant, but sensitive to the Imipeneme and to the aminosides. The evolution was lethal in a picture of multivisceral failing in spite of a bi-antibiotherapy and under hypo-uricemia treatment prescription.展开更多
Objective: To explore the anti-inflammatory effect of luteolin on rats with acute gout arthritis. Methods: A total of forty-eight rats were chosen and randomly divided into six groups. The acute gout arthritis model o...Objective: To explore the anti-inflammatory effect of luteolin on rats with acute gout arthritis. Methods: A total of forty-eight rats were chosen and randomly divided into six groups. The acute gout arthritis model of rats was established by injecting monosodium urate at the concentration of 25 mg/mL into the ankle joint cavity. Changes of joint swelling index at different time points and the levels of IL-1β, IL-17, TNF-α, IL-6 in serum and synovial were measured. Results: Compared with the control group, the swelling index of ankle joint and gait score in the model group was significantly enhanced at different time points (all P<0.01). Compared with the MSU group, luteolin improved the ankle swelling index of rats with acute gout arthritis (P<0.05), and significantly down-regulated the levels of IL-1β, IL-17, TNF-α, IL-6 (P<0.01). Conclusion: Luteolin can alleviate the inflammatory response of acute gouty arthritis and may be an effective drug for acute gouty arthritis.展开更多
BACKGROUND Gout and seronegative rheumatoid arthritis(SNRA)are two distinct inflammatory joint diseases whose co-occurrence is relatively infrequently reported.Limited information is available regarding the clinical m...BACKGROUND Gout and seronegative rheumatoid arthritis(SNRA)are two distinct inflammatory joint diseases whose co-occurrence is relatively infrequently reported.Limited information is available regarding the clinical management and prognosis of these combined diseases.CASE SUMMARY A 57-year-old woman with a 20-year history of joint swelling,tenderness,and morning stiffness who was negative for rheumatoid factor and had a normal uric acid level was diagnosed with SNRA.The initial regimen of methotrexate,leflunomide,and celecoxib alleviated her symptoms,except for those associated with the knee.After symptom recurrence after medication cessation,her regimen was updated to include iguratimod,methotrexate,methylprednisolone,and folic acid,but her knee issues persisted.Minimally invasive needle-knife scope therapy revealed proliferating pannus and needle-shaped crystals in the knee,indicating coexistent SNRA and atypical knee gout.After postarthroscopic surgery to remove the synovium and urate crystals,and following a tailored regimen of methotrexate,leflunomide,celecoxib,benzbromarone,and allopurinol,her knee symptoms were significantly alleviated with no recurrence observed over a period of more than one year,indicating successful management of both conditions.CONCLUSION This study reports the case of a patient concurrently afflicted with atypical gout of the knee and SNRA and underscores the significance of minimally invasive joint techniques as effective diagnostic and therapeutic tools in the field of rheumatology and immunology.展开更多
文摘Rheumatoid arthritis (RA) and gout are common diseases, but their coexistence is rare. We describe the case of a 76-year-old man with hypertension who had been treated for gout for 20 years on allopurinol and colchicine. He was seen in consultation for deforming polyarthritis of the small and large joints, which had been evolving for about 2 years. The acute episode occurred 10 days earlier with the onset of bilateral and symmetrical polyarthritis affecting the large and small joints. The physical examination revealed a peripheral joint syndrome with ulnar gale force deformities of the hands and several buttonhole deformities of the fingers. In addition, there were nodules, some of which were fistulised, giving rise to a chalky slurry. The biology revealed an inflammatory syndrome in addition to rheumatoid factors and ACPA, which were elevated. Biological analysis of the nodular fluid revealed clusters of sodium urate crystals and ultrasound scans of the joints revealed a double-contour appearance in several joints. The diagnosis of RA was made using the 2010 ACR/EULAR criteria. The patient was treated as an outpatient with corticosteroids before being put on methotrexate. It is important to understand that these two conditions can occur at the same time, so it is important to consider them when treating patients with gout or RA.
基金This work was supported by the Project of State Administration of Traditional Chinese Medicine of Sichuan Province of China(No.2020HJZX001)。
文摘Background:Gout is an inflammatory joint disease.Modern pharmacological studies have shown that Zanthoxylum bungeanum(Z.bungeanum)has significant anti-inflammatory and osteoprotective effects.This study is aimed to explore the therapeutic effect of Z.bungeanum on gouty arthritis.Methods:Firstly,the compounds in the water extract of Z.bungeanum(WZB)were analyzed by UPLC-QE-Orbitrap-MS/MS.The compounds and disease targets were predicted using SwissTargetPrediction platform and GeneCards database,and the candidate targets were acquired by taking the intersection.Next,the protein interaction network was constructed and the hub genes were screened using String platform and Cytoscape software.Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes analysis of hub genes were performed using Metascape platform.Finally,the disease-pathway-target-drug-component network diagram was constructed to obtain the active components and targets for treating disease,and the affinity between components and targets were predicted by applying Discovery Studio software.In vitro,using an acute gout model of RAW 264.7 macrophages induced by Monosodium Urate to evaluate the anti-inflammatory effect of WZB on Gout.Meanwhile,we established a mice model of hyperuricemia and measured the serum xanthine oxidase(XOD)activity and uric acid(UA)contents.Results:A total of 20 chemical components were identified from WZB,mainly alkaloid components.The network pharmacology results showed that Dihydrobungeanool,Quercetin,Hydroxy-α-sanshool and Hydroxy-ɛ-sanshool were the main active components of WZB against gout.MAPK1,PIK3CA,EGFR and TLR1 proteins were the main targets of WZB in the treatment of gout.Pathways in cancer,PI3K/Akt signaling pathway,Th17 cell differentiation and MAPK signaling pathway were closely related to anti-gout.Molecular docking results have shown that Dihydrobungeanool may be the main active ingredient of WZB for gout treatment,and PIK3CA is the main potential target.The cellular gout model showed that WZB significantly reduced IL-1βand TNF-αinflammatory factor levels and influenced the expression of PI3K protein.In addition,WZB administration effectively reduced UA levels and XOD activity in the serum of mice with hyperuricemia.Conclusion:Our study results suggest that WZB could treat gout by acting on PIK3CA gene target to reduce the level of inflammatory factors,and reduce XOD activity to lower UA levels.
文摘We’re reporting the case of an arthritis to banal germ occurred in concomitance with an advanced polyarticular of gout. It was about a patient of 59 years with alcoholic and gouty chronicle more than 10 years, but without specialized medical follow-up. He has been admitted in hospitalization for a big inflammatory and stiff right knee, letting rising the pus through two cutaneous fistulas in a context of non-febrile change of his peripheral polyarthritis of the big and small articulations. Gout was at distal predominance, bilateral, distorting, tophaceous and active. Inflammatory syndrome was important (ESR = 50 mm in the 1st hour and CRP = 28 mg/l) and uricemia was high, at 84 mg/l. The glycaemia, the hepatic, the viral, renal and serological evaluation (HIV and B, C hepatitis) were normal. The bacteriological analysis of the pus collected after puncture of the knee and cleaning identified a negative gram bacillus, Morganella morganii, multi-resistant, but sensitive to the Imipeneme and to the aminosides. The evolution was lethal in a picture of multivisceral failing in spite of a bi-antibiotherapy and under hypo-uricemia treatment prescription.
基金supported by Hainan Health and Family Planning Industry Scientific Research Project(Grant No.18A200018).
文摘Objective: To explore the anti-inflammatory effect of luteolin on rats with acute gout arthritis. Methods: A total of forty-eight rats were chosen and randomly divided into six groups. The acute gout arthritis model of rats was established by injecting monosodium urate at the concentration of 25 mg/mL into the ankle joint cavity. Changes of joint swelling index at different time points and the levels of IL-1β, IL-17, TNF-α, IL-6 in serum and synovial were measured. Results: Compared with the control group, the swelling index of ankle joint and gait score in the model group was significantly enhanced at different time points (all P<0.01). Compared with the MSU group, luteolin improved the ankle swelling index of rats with acute gout arthritis (P<0.05), and significantly down-regulated the levels of IL-1β, IL-17, TNF-α, IL-6 (P<0.01). Conclusion: Luteolin can alleviate the inflammatory response of acute gouty arthritis and may be an effective drug for acute gouty arthritis.
基金Supported by Natural Science Foundation of Guangdong Province,No.2023A1515011213。
文摘BACKGROUND Gout and seronegative rheumatoid arthritis(SNRA)are two distinct inflammatory joint diseases whose co-occurrence is relatively infrequently reported.Limited information is available regarding the clinical management and prognosis of these combined diseases.CASE SUMMARY A 57-year-old woman with a 20-year history of joint swelling,tenderness,and morning stiffness who was negative for rheumatoid factor and had a normal uric acid level was diagnosed with SNRA.The initial regimen of methotrexate,leflunomide,and celecoxib alleviated her symptoms,except for those associated with the knee.After symptom recurrence after medication cessation,her regimen was updated to include iguratimod,methotrexate,methylprednisolone,and folic acid,but her knee issues persisted.Minimally invasive needle-knife scope therapy revealed proliferating pannus and needle-shaped crystals in the knee,indicating coexistent SNRA and atypical knee gout.After postarthroscopic surgery to remove the synovium and urate crystals,and following a tailored regimen of methotrexate,leflunomide,celecoxib,benzbromarone,and allopurinol,her knee symptoms were significantly alleviated with no recurrence observed over a period of more than one year,indicating successful management of both conditions.CONCLUSION This study reports the case of a patient concurrently afflicted with atypical gout of the knee and SNRA and underscores the significance of minimally invasive joint techniques as effective diagnostic and therapeutic tools in the field of rheumatology and immunology.
