Elderly Patients Exhibit Stronger Inflammatory Responses during Gout Attacks.
10.3346/jkms.2017.32.12.1967
- Author:
Jae Hyun LEE
1
;
Ji Ae YANG
;
Kichul SHIN
;
Ga Hye LEE
;
Won Woo LEE
;
Eun Young LEE
;
Yeong Wook SONG
;
Eun Bong LEE
;
Jin Kyun PARK
Author Information
1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea. jinkyunpark@gmail.com
- Publication Type:Original Article
- Keywords:
Gout;
Aging;
Fever;
C-reactive Protein;
Inflammation
- MeSH:
Aged*;
Aging;
Arthritis, Infectious;
Blood Sedimentation;
C-Reactive Protein;
Fever;
Flow Cytometry;
Gout*;
Humans;
Inflammation;
Monocytes;
Retrospective Studies;
Uric Acid
- From:Journal of Korean Medical Science
2017;32(12):1967-1973
- CountryRepublic of Korea
- Language:English
-
Abstract:
Gout attacks are often accompanied by systemic inflammatory response. The aim of the retrospective study was to compare gout patients in different age groups in terms of their clinical features at gout attacks. Patients, who were treated for gout attack in two tertiary medical centers between January 2000 and April 2014, were divided into young (≤ 50 years), middle-aged, and elderly (> 65 years) groups. Patients in three age groups were compared in terms of presence of fever (> 37.8°C), C-reactive protein (CRP) levels, and erythrocyte sedimentation ratio (ESR) at the gout attacks. Monocytes, which were isolated from 10 consecutive patients who previously experienced gout attacks, were stimulated with monosodium urate (MSU) crystals and cytokine production was measured by flow cytometry. Among 254 patients analyzed in this study, 48 were young, 65 were middle-aged, and 141 were elderly. The elderly patients were more likely to have fever (51.1%) during the attack than the young (20.8%) and middle-aged (30.8%) patients (P < 0.001 by χ² test). They were also more likely to have higher ESR and CRP levels than the young patients (P = 0.002 for ESR, P < 0.001 for CRP). Patients' age correlated significantly with CRP and ESR levels (both P < 0.001). After stimulation with MSU, the production of interleukin-1β by monocytes increased with patients' age (r = 0.670, P = 0.03). In conclusion, gout attacks in elderly patients are associated with fever and higher ESR and CRP levels, often resembling a septic arthritis.
