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Elderly Patients Exhibit Stronger Inflammatory Responses during Gout Attacks.
Jae Hyun Lee1, Ji Ae Yang1, Kichul Shin2
1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Journal of Korean Medical Science
|November 9, 2017
Summary
Elderly gout patients frequently experience fever and elevated inflammatory markers like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). These symptoms in older adults can mimic septic arthritis, highlighting age-related differences in gout attacks.
Area of Science:
- Rheumatology
- Internal Medicine
- Geriatrics
Background:
- Gout attacks are characterized by systemic inflammation.
- Clinical presentation of gout can vary with patient age.
Purpose of the Study:
- To compare clinical features of gout attacks across different age groups.
- To investigate age-related differences in inflammatory responses during gout attacks.
Main Methods:
- Retrospective study of 254 gout patients (young, middle-aged, elderly).
- Comparison of fever, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR) during attacks.
- In vitro monocyte stimulation with monosodium urate (MSU) crystals to measure cytokine production.
Main Results:
- Elderly patients (≥65 years) showed higher prevalence of fever (51.1%) compared to younger groups.
- Elderly patients exhibited significantly higher ESR and CRP levels.
- Monocyte production of interleukin-1β increased with patient age after MSU stimulation.
Conclusions:
- Gout attacks in the elderly are associated with more pronounced systemic inflammation, including fever, elevated CRP, and ESR.
- Clinical presentation of gout attacks in elderly patients can resemble septic arthritis.
- Age is a significant factor influencing inflammatory response and clinical manifestation of gout attacks.
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