Gouty Artritis
Gouty Artritis
Gout
DEFINISI :
Artritis perifer akibat dari deposit kristal sodium
Gout
Affects less than 0.5% of the population
Due to familial disposition, incidence may be as
Gout
Empat tahap perkembangan Gout:
asymptomatic hyperuricemia
acute gouty arthritis
interval or intercritical gout
chronic or tophaceous gout
Pathophysiology
vaskularisasi
Kartilago
Tendon/ligamen
Pathophysiology
GOUT PRIMER
METABOLISME PURIN
Pathophysiology
GOUT SEKUNDER
Pathophysiology
GOUT SEKUNDER
Chronic:
Destructive tophacous
Much greater chance if untreated
Diagnosis
Pemeriksaan fisik
Konfirmasi arthrocentesis
Pengumpulan urin
Kadar asam urat normal dalam 24 jam : 250 750 mg
Microscopic Diagnosis
X-ray
Acute
Chronic
makanan laut
Karbohidrat : kurangi karbohidrat sederhana spt
gula, permen
Sesuaikan kebutuhan kalori
Rendah protein
Rendah lemak
Banyak minum
PENANGANAN FARMAKOLOGI
SASARAN TERAPI :
1. Meringankan bengkak dan rasa sakit pd gout akut
(AINS, kortikosteroid, kolkisin)
2. Menurunkan konsentrasi asam urat plasma
(allopurinol, probenesid, sulfinpirazon)
3. Mencegah kekambuhan (allopurinol, kolkisin
probenesid, sulfinpirazon)
4. Mencegah dan mengurangi pembentukan tophi
(probenesid, sulfinpirazon)
5. Mengatasi batu ginjal karena asam urat (allopurinol)
Prognosis
Generally good
More severe course when present < 30 years old
Up to 50% progress to chronic disease if untreated.
Surgical intervention may be required for tophi.