[What remains of gout in 1993?]

Gout is a disease caused by deposits of sodium urate crystals in tissues. This disease, already known of Hippocrates, is now due to new causes, notably iatrogenic, and has new clinical forms. The typical initial attack usually occurs in men in their fifties and affects the big toe; in the absence of treatment it evolves towards chronic tophaceous gout. When gout occurs in subjects younger than 30 years, these must be investigated for enzyme deficit which is usually partial. The incidence of gout in women is ever increasing, being encouraged by treatments with diuretic drugs. Gout is often atypical, affecting predominantly the hands and with rapid development of tophus. In transplanted patients other drugs, such as cyclosporin, may induce an early, polyarticular and tophaceous gout. Alcohol is a facilitating factor of hyperuricaemia. Disturbances of metabolism, such as hyperlipidaemia, obesity or arterial hypertension, are often associated with hyperuricaemia. With an early and well-conducted treatment the passage to chronicity and the occurrence of complications can be avoided.