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Gout Tophi

June 10, 2011 by Lynn.

A tophus (plural: tophi) is a deposit or lump of uric acid crystals that forms in people with gout, a type of arthritis. Tophus means "stone" in Latin. Gout is a condition where the body has overly high levels of uric acid in the blood, either because it can not rid itself of, or produces too much uric acid.

Uric acid is a naturally occurring chemical produced when the body breaks down purines, an organic compound found in the body and in most foods. In normal quantities, uric acid is a natural and healthy antioxidant, helping to prevent damage to blood vessels.

But when too much uric acid circulates in the blood it builds up, forming painful needle-like crystals and, in some cases, knobby, chalky lumps called tophi. Uric acid can also accumulate in the kidneys, causing kidney stones, or, less frequently, in the tendons or other organs.

It's estimated about 25 percent of people with gout will eventually develop tophi. Tophi usually take many years to develop, appearing about 10 years after the onset of untreated or poorly managed gout, although they may appear earlier or later. They appear most often in the elderly, especially elderly women.

Tophi can form under the skin or in the joints, bones and cartilage. They commonly occur on the ears, fingers, toes, ankle and elbow. They first form as movable lumps, and become whitish and painful as they grow bigger. Gout sufferers often develop more than one tophi.

If allowed to continue to grow, tophi can deform and destroy joints and cartilage. They can also become infected and burst, oozing through the skin or causing a life threatening bacterial infection in the blood.

Tophi can be reabsorbed into the body if uric acid levels are decreased. Therefore they are treated by reducing the body's level of uric acid with gout medication. This can take months, or even years. Febuxostat (brand name Uloric) and pegloticase (brand name Krystexxa) are two of the most effective uric acid reducing tophi and gout medications.

Gout medications must be taken with care however, as the reabsorption of a tophus can raise uric acid levels in the blood, precipitating a gout attack. In some cases, tophi will need to be removed surgically.


Filed under: Gout Arthritis.

Tags: gout tophi, tophaceous gout, gout medication, colchicine for gout, colchicine, colcyrs, colchicine information.


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