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Current Rheumatology Reports
Published in: Current Rheumatology Reports 3/2015

01-03-2015 | Crystal Arthritis (MH Pillinger and S Krasnokutsky, Section Editors)

The Gouty Tophus: a Review

Authors: Ashika Chhana, Nicola Dalbeth

Published in: Current Rheumatology Reports | Issue 3/2015

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Abstract

The tophus is the cardinal feature of advanced gout. This review summarises recent research into the biology, impact and treatment of tophaceous gout. Microscopically, tophi are chronic foreign body granuloma-like structures containing collections of monosodium urate (MSU) crystals surrounded by inflammatory cells and connective tissue. Extracellular trap formation mediated by neutrophil interactions with MSU crystals may be a central checkpoint in tophus formation. Gouty tophi impact on many aspects of health-related quality of life. Tophi are also implicated in the development of structural joint damage and increased mortality risk in people with gout. Effective treatment of tophaceous gout requires long-term urate-lowering therapy, ideally to achieve a serum urate concentration of <5 mg/dL (300 μmol/L). Recent advances in gout therapeutics have expanded urate-lowering therapy options for patients with severe tophaceous disease to allow faster regression of tophi, improved health-related quality of life and, potentially, improved structural outcomes.
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Metadata
Title
The Gouty Tophus: a Review
Authors
Ashika Chhana
Nicola Dalbeth
Publication date
01-03-2015
Publisher
Springer US
Published in
Current Rheumatology Reports / Issue 3/2015
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-014-0492-x

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