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[Summary of the Dutch College of General Practitioners' "Gout" Standard].
Ned Tijdschr Geneeskd. 2002 Feb 16; 146(7):309-13.NT

Abstract

The typical form of acute gout can be clinically diagnosed. The term 'complicated gout' is used if there are more than three acute attacks of gout per year, tophi or urate stones in the urinary tracts. In the case of recurrent probable acute gout, a diagnostic fine needle aspirate from the joint during an attack is indicated. First choice treatment of acute gout consists of NSAIDs. Colchicine is the second choice treatment and the third choice treatment consists of corticosteroids. Excessive alcohol use should be limited. Treatment of chronic gout depends on the uric acid excretion in the 24-hour urine. If the level of excretion is too low, the first choice should be benzbromarone, and if the uric acid output is too high, allopurinol should be the treatment of first choice. Increased fluid intake is recommended; maintenance treatment with colchicine is not advised. Consultation with or referral to a rheumatologist is indicated in the case of doubt about the diagnosis of 'acute gout' or 'complicated gout', or (suspected) bacterial arthritis and insufficient treatment effect.

Authors+Show Affiliations

Romeijnders AC
Nederlands Huisartsen Genootschap, afd. Richtlijnontwikkeling en Wetenschap, Postbus 3231, 3502 GE Utrecht.
Gorter KJ
No affiliation info available

MeSH

Acute DiseaseAdrenal Cortex HormonesAllopurinolAnti-Inflammatory Agents, Non-SteroidalBenzbromaroneChronic DiseaseColchicineGoutGout SuppressantsHumansNetherlandsPractice Guidelines as TopicRecurrenceUricosuric Agents

Pub Type(s)

English Abstract
Journal Article

Language

dut

PubMed ID

11876034

Citation

Romeijnders, A C M., and K J. Gorter. "[Summary of the Dutch College of General Practitioners' "Gout" Standard]." Nederlands Tijdschrift Voor Geneeskunde, vol. 146, no. 7, 2002, pp. 309-13.
Romeijnders AC, Gorter KJ. [Summary of the Dutch College of General Practitioners' "Gout" Standard]. Ned Tijdschr Geneeskd. 2002;146(7):309-13.
Romeijnders, A. C., & Gorter, K. J. (2002). [Summary of the Dutch College of General Practitioners' "Gout" Standard]. Nederlands Tijdschrift Voor Geneeskunde, 146(7), 309-13.
Romeijnders AC, Gorter KJ. [Summary of the Dutch College of General Practitioners' "Gout" Standard]. Ned Tijdschr Geneeskd. 2002 Feb 16;146(7):309-13. PubMed PMID: 11876034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Summary of the Dutch College of General Practitioners' "Gout" Standard]. AU - Romeijnders,A C M, AU - Gorter,K J, PY - 2002/3/6/pubmed PY - 2002/7/13/medline PY - 2002/3/6/entrez SP - 309 EP - 13 JF - Nederlands tijdschrift voor geneeskunde JO - Ned Tijdschr Geneeskd VL - 146 IS - 7 N2 - The typical form of acute gout can be clinically diagnosed. The term 'complicated gout' is used if there are more than three acute attacks of gout per year, tophi or urate stones in the urinary tracts. In the case of recurrent probable acute gout, a diagnostic fine needle aspirate from the joint during an attack is indicated. First choice treatment of acute gout consists of NSAIDs. Colchicine is the second choice treatment and the third choice treatment consists of corticosteroids. Excessive alcohol use should be limited. Treatment of chronic gout depends on the uric acid excretion in the 24-hour urine. If the level of excretion is too low, the first choice should be benzbromarone, and if the uric acid output is too high, allopurinol should be the treatment of first choice. Increased fluid intake is recommended; maintenance treatment with colchicine is not advised. Consultation with or referral to a rheumatologist is indicated in the case of doubt about the diagnosis of 'acute gout' or 'complicated gout', or (suspected) bacterial arthritis and insufficient treatment effect. SN - 0028-2162 UR - https://www.unboundmedicine.com/medline/citation/11876034/[Summary_of_the_Dutch_College_of_General_Practitioners'_"Gout"_Standard]_ L2 - https://medlineplus.gov/gout.html DB - PRIME DP - Unbound Medicine ER -