GOUT Prof Dr AMC Karema-K, SpPD-KR Dr Jerey A.Ongkowiaya, SpPD Di!.Rema"o#ogi $ag.%#m& Penyaki" Da#am 'K Un(ra")RSU Prof *r RD Kan*o&
Pen*a+&#&an
Penyaki" yang *i(eakan *epo(i" mikrokri("a# mikrokri("a# MSU a"a& AU *ari airan "&&+ yang +iper&ri(emia Gamaran ar"ri"i( ak&", ak&", "eno(ino!i(i"i(, &r(i"i(, (e#&#i"i(, *epo(i" "o/(e&(, penyaki" gina# *an &ro#i"ia(i( %n(i*en pria wani"a 01 2, 3 45 "+ Kon(en"ra(i AU er+&&ngan *engan fak"or *emogra/, &(ia, eni( ke#amin, ma((a "&&+, fak"or gene"ik6 &ga "erkai" ("a"&( (o(ia#, $$, 7, kon(&m(i a#ko+o# *an *ie" "inggi pro"ein
Pa"o#ogi *an Pa"ogene(i(
A(am Ura" mer&pakan pro*&k ak+ir me"ao#i(me p&rin 859 *ipero#e+ *ari ka"ao#i(me makanan yang mengan*&ng p&rin :)2 *iek(kre(i me#a#&i gina# *an 0)2 me#a#&i (i("em G% 7iper&ri(emia "era*i akia" pe ↑ (in"e(i( a"a& pe ↓ ek(kre(i
Penyea $erk&rangnya ;k(kre(i ;k(kr e(i A(am Ura" Gina# Primer :
%*iopa"ik 'ami#ia" J&!eni#e Go&"+y
7iper"en(i, Peningka"an ka*ar a(am organik =OR, ke#aparan, a#ko+o#>, De+i*ra(i, Oa" =*i&re"ik, a(e"o(a#, pira?inami*>, CKD *##
Penye enyea a Pening eningka"an ka"an Pro*&k(i A(am Ura" Primer :
%*iopa"ik De/(ien(i en?im 7GPRT Sekunder :
De/(ien(i g#&o(e 8-fo(fa"a(e Gg #imfopro#ifera"if #imfopro#ifera"if *an mie#opro#ifera"if mie#opro#ifera"if =7o*gkin, @e&kemia, MM, Po#i(i"emia> Oa" (i"o"ok(ik Kar(inoma"o(i( Kar(inoma"o(i( *##
Gamaran K#ini( 0.
7iper&ri(emia a(imp"oma"ik
:.
Go&" ak&"
2.
Go&" in"erkri"ika#
4.
Go&" "ofa(e&( kronik
Go&" Ak&"
Serangan % (ering pa*a pria 25 85 "+
Monoar"ik&#ar, arang yang po#iar"ik&#ar Ter(ering Ter(ering pa*a MTP %, i(a &ga pa*a p a*a perge#angan kaki)"angan, #&"&", (ik&, (en*i: kei# *i "angan)kaki
'ak"or pene"&( "ra&ma, ak"i!i"a( /(ik, opera(i, *ie" ke"a" a"a& er#ei+an, a#ko+o#, oa":an
Go&" Ak&"
Serangan % ia(anya "ia-"ia
Sen*i "ampak mera+, pana(, engkak, (anga" nyeri
Dapa" *i(er"ai *emam, #eko(i" #eko(i" ↑, @;D ↑ Serangan yang "i*ak *ioa"i akan (em&+ *engan (en*irinya
Go&" Tofa(e&( Kronik Tera*i Tera*i (e"e#a+ (erangan ak&" ak&" er&#ang *an *i(er"ai pemengkak p emengkakan an (en*i a(ime"ri( To/ To/ ak&m&#a(i ak&m&#a(i ma(if *ari mikrokri("a# mikrokri("a# AU *an &ra" amorf *g *ik * ike#i#ingi e#i#ingi +i("io(i", gian" e## *an /ro(i( *apa" "&m&+ *i ar.periar"ik&#ar, rawan "e#inga, &r(a *an "en*on (+ea"+ 859 pa(ien +iper&ri(emi yang "i*ak *ioa"i akan "eren"&k "o/ (e"e#a+ 05 "+
Diagno(i(
Kri"eria +iper&ri(emia =C%OMS> a*a#a+ 3 1 mg)*# =pria> *an 3 8 mg)*# =wani"a>
Kri"eria *iagno(i( Ar"ri"i( Go&" er*a(arkan kri"eria Amerian R+e&ma"i(m A((oia"ion 0B11
Kri"eria AR ARA A 0B11
A*anya kri("a# &ra" yang k+a( *i airan (en*i, a"a& A*anya "of&( yang "er&k"i eri(i kri("a# &ra" (eara kimiawi a"a& mikro(kop mikro(kop po#ari(a(i a+aya, a"a& Di*apa"kan 8 *ari 0: fenomena erik&"
Kri"eria AR ARA A 0B11 =#an&"an> 0. :. 2. 4. . 8.
@ei+ *ari 0 ka#i (erangan ak&" ak&" Ra*ang mak(ima# "era*i *a#am 0 +ari Serangan ar"ri"i( monoar"ik&#ar monoar"ik&#ar Kemera+an (en*i
Kri"eria AR ARA A 0B11 =#an&"an> 1. Serangan &ni#a"era# "+* (en*i "ar(a# . Ke&rigaan Ke&rigaan a*anya "of&( "o f&( B. 7iper&ri(emia 05. Pemengkakan a(ime"ri( p* 0 (en*i =E-ray> 00. Ki("a (&kor"ika# "anpa ero(i =E-ray> 0:. K&#"&r nega"if mikroorgani(me airan (en*i (e#ama (erangan ak&"
Diagno(i( $an*ing Akut :
Ar"ri"i( infek(i $&r(i"i(, (e#&#i"i(, "eno(ino!i(i"i( Ar"ropa"i Ar"ropa"i kri("a# #ain Ar"ri"i( a"ra&ma"ik Ar"ri"i( P(oria"ik *## Kronik:
Pena"a#ak(anaan Serangan ak&" 0. %("ira+a"kan (en*i yang "erkena
Pena"a#ak(anaan Jangka panang A##op&rino# meng+ama" Fan"in 0. ok(i*a(e (+g "*k "era*i kon!er(i Fan"in)+ipoFan"in mena*i a(am &ra" :. Oa" &riko(&rik =proenei* *an (&#/npyra?one> k.i. k a*a o!er pro*&k(i a(am &ra", gro(( &riko(&ria, pF *g CKD a"a& &ro#i"ia(i( &ra" $en?romarone k oa" &riko(&rik "i*ak 2. efek"if *an +iper(en(i"i!i"a( "+* a##op&rino#
Pena"a#ak(anaan Die" 7iper&ri(emia a(imp"oma"ik "i*ak memer#&kan "erapi pro/#ak(i( T&r&nkan T&r&nkan $$ *an Tek.Dara+ Tek.Dara+ k mem&ngkinkan +in*ari pengg&naan *i&re"ik =meng+ama" ek(kre(i AU> +a"i-+a"i pengg&naan AC;-in+ii"or karena karena *apa" menyeakan re"en(i AU, AR$ #ei+ aik karena memp&nyai efek &riko(&rik
Manife("a(i Go&" pa*a Sa#&ran Kemi+
Uro#i"ia(i(
