- Gout is a disease characterized by recurrent attacks of arthritis; urate deposits in the joints, kidneys, and other tissues; and elevated blood and urine uric acid levels.  The joint most commonly affected initially is the metatarsophalangeal joint of the great toe.  There are two forms of "primary" gout.  In one, uric acid production is increased because of various enzyme abnormalities.  In the other, there is a selective deficit in renal tubular transport of uric acid.  In "secondary" gout, the uric acid levels in the body fluids are elevated as a result of decreased excretion or increased production secondary to some other disease process.  For example, excretion is decreased in patients treated with thiazide diuretics and those with renal disease.  Production is increased in leukemia and pneumonia because of increased breakdown of uric acid-rich white blood cells.
- The treatment of gout is aimed at relieving the acute arthritis with drugs such as colchicine or nonsteroidal anti-inflammatory agents and decreasing the uric acid level in the blood.  Colchicine does not affect uric acid metabolism, and it apparently relieves gouty attacks by inhibiting the phagocytosis of uric acid crystals by leukocytes, a process that in some way produces the joint symptoms.  Phenylbutazone and probenecid inhibit uric acid reabsorption in the renal tubules.  Allopurinol, which directly inhibits xanthine oxidase in the purine degradation pathway, is one of the drugs used to decrease uric acid production.


Reference:
1. Ganong's Review of Medical Physiology: 23rd Edition.  Kim E. Barrett et al.  McGraw-Hill Publishing. 2010.