Gout Treatment of a 49-year-old Chinese-American Man
Clinical Pearls of Wisdom Q&A CaseGout affects 8.3 million Americans according to NHANES 2007–2008, roughly 3.9% of the U.S. population. Gout has significant impact on physical function, productivity, health-related quality of life and health care costs.
Compared to whites, racial/ethnic minorities have higher prevalence of gout and there is a wide variation in the prevalence of gout in various populations in the Asia‐Pacific region. There's something else as well.
In the following gout treatment case, we'll glean a pearl of wisdom about assessing gout risk and applying gout treatment.
Gout Treatment Case:
A 49-year-old Chinese American man was recently treated for a recurrent gout flare in his right first metatarsal-phalangeal joint. He was treated with naproxen sodium and colchicine, and his flare resolved.
Previously, he had painful ureterolithiasis, and stone analysis revealed the stones to be uric acid stones.His serum uric acid level is 9 mg/dL. His prior medical history is significant for hypertension, for which he takes amlodipine. He has normal renal function and his creatinine is 0.9 mg/dL. Due to his recurrent gout and hyperuricemia, uric acid lowering therapy is planned.Question:
What is the correct next step in the gout treatment of this patient?
Answer Options:
Start allopurinol 100mg daily.
Initiate treatment with probenecid 250mg twice daily.
Start allopurinol 300mg daily.
Test patient for the human leukocyte antigen (HLA)-B*58:01 allele.
See the Answer:
About the Author:
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