Journal of leukocyte biology

Running head: INTEGRATED CASE STUDY
INTEGRATED CASE STUDY
Name of the student:
Name of the university:
Author note:

INTEGRATED CASE STUDY
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Table of Contents
Introduction:....................................................................................................................................2
Discussion:.......................................................................................................................................2
Etiology and pathophysiology:.................................................................................................2
Clinical signs and symptoms and diagnosis:...........................................................................4
Treatment and complication:...................................................................................................5
Conclusion:......................................................................................................................................6
References:......................................................................................................................................8

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Introduction:
Gout is considered as joint inflammation, most frequently in the first metatarsophalangeal
joint. Counsell et al. (2018), suggested that the systematic disease caused by monosodium urate
crystals deposition in a joint space. According to the Australian Bureau of Statistics 2017–18
National Health Survey, approximately 187000 Australian are suffering from gout In Australia,
it distresses about 70,000 people each year (Ting et al., 2016). Gout is most common amongst
males compared to females. Obesity, Hyperuricemia, male and consumption of certain
medications are considered risk factors for developing gout. Individuals with acute onset joint
pains are at high risk of developing gout (Rogenmoser & Arnold, 2018). The case study involves
a patient who admitted to the hospital due to severe pain in his right big toe. The patient had a
history of hypertension and hyperlipidemia. The report aims to provide etiology and risk factors
of gout, pathophysiology of gout, diagnosis and recommendation for managing ground in the
following paragraphs.
Discussion:
Etiology and pathophysiology:
Risk factors:
Gout is defined as joint inflammation, most frequently in the first metatarsophalangeal
joint. Hyperuricemia is the leading cause of gout. People with higher serum urate levels are at
high risk of developing gout (Ahmed et al., 2020). While Hyperuricemia is not the leading cause
of gout, older age, male sex, obesity, a purine diet, metabolic syndrome, alcohol consumption,
comorbid disease, and genetics are considered as the risk factors for developing the disease. The
case study suggested that Steven is male , obese ( 88kg) and metabolic syndrome like diabetes
type two, indicating that these are the risk factors for developing gout. Moreover, Steven is meat

INTEGRATED CASE STUDY
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eater and drinks alcohol which might be the reason behind development of gout. On the other
hand, consuming medications such as low dose aspirin, ethambutol, pyrazinamide, and
cyclosporine can result in gout. Proudman et al. (2019), highlighted that family history and
presence of genetic factors such as SLC2A9, ABCG2, SLC22A12, GCKR, and PDZK1 is
contributed factors for gout. Individuals with dietary habits such as shrimp, lobster, and red meat
are more likely to develop gout as discussed (Vieira et al., 2017). Moreover, high blood pressure
is another risk factor for gout as observed in this case study. The vital signs of Steven suggested
that he has high blood pressure (140/80 whereas normal blood pressure must be 120/80) which
can contributed to development of gout as high blood pressure increase uric acid level (Johnson
et al., 2019).
Triggers:
Proudman et al. (2019), suggested that every conditional that causes an alteration in the
deposition of extracellular urate concentration has the ability to trigger symptoms of gout. The
conditions that can trigger develop gout include surgical procedure, recent trauma, dietary factors
such as fatty food and alcohol. Metabolic symptoms can trigger the development as observed in
this case study (Craft et al., 2019). The patient had a history of diabetes and hyperlipidemia
which are the metabolic diseases that might be the reason behind the development of gout.
Pathophysiology:
Due to the presence of risk factors mentioned above, dysfunction of the purine
metabolism observed which resulted in hyperuricemia. Uric acid of the blood usually deposited
from endogenous purine breakdown and exogenous sources. The overproduction of uric acid
leads to the rise of serum uric acid levels and it can promote monosodium urate crystal
nucleation. Inflammation experience amongst patients when macrophages phagocytize