TY - JOUR
T1 - Polyarticular gout attacks following cerebrovascular accidents
T2 - Is hemiparesis in fact protective? 2 cases and a review of the literature
AU - Hsiao, Susan J.
AU - Vaynrub, Maksim
AU - Furer, Victoria
AU - Samuels, Jonathan
N1 - Funding Information:
This study was funded by an Asthma UK Grant to IS, IPH, DES, and CEB (AUK-PG-2013-188) and additional Asthma UK funding to IS and DES (grants 10/006 and 11/031). Genotyping in GASP was additionally supported by Rosetrees Trust (grant to IS) and AirPROM (CEB, MT, and IS). This work was supported by the Medical Research Council (grant number MC_PC_12010), a Strategic Award to IPH, MDT, LVW, and Professor David Strachan. LVW holds a GSK/British Lung Foundation Chair in Respiratory Research. Asthma UK funded the GASP initiative (AUK-PG-2013-188). This work was part funded by the NIHR Leicester Respiratory Biomedical Centre. AS is supported by the NIHR Manchester Biomedical Research Centre. MAAS was supported by the Asthma UK grants (no. 301, 1995-1998; no. 362, 1998-2001; no. 01/012, 2001-2004; no. 04/014, 2004-2007; BMA James Trust, 2005; The JP Moulton Charitable Foundation, 2004-current; The North west Lung Centre Charity, 1997-current; the Medical Research Council (MRC) G0601361, 2007-2012; MR/K002449/1, 2013-2014; and MR/L012693/1, 2014-2018). The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, UMCG (the Netherlands), University Groningen, and the Northern Provinces of the Netherlands. This study was also supported by a Lung Foundation of the Netherlands Dutch Lung Foundation (grant nos. AF 95.05, AF 98.48, and AF3.2.09. 081JU), the UMCG, Dutch TerMeulen Fund, and the Ubbo Emmius Fund (University of Groningen). The authors would like to thank Carl Nelson of Nottingham Trent University for his kind donation of HEK-NF-?B-SEAP reporter cells. The authors also wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants.
Funding Information:
This study was funded by an Asthma UK Grant to IS, IPH, DES, and CEB (AUK-PG-2013-188) and additional Asthma UK funding to IS and DES (grants 10/006 and 11/031). Genotyping in GASP was additionally supported by Rosetrees Trust (grant to IS) and AirPROM (CEB, MT, and IS). This work was supported by the Medical Research Council (grant number MC_PC_12010), a Strategic Award to IPH, MDT, LVW, and Professor David Strachan. LVW holds a GSK/British Lung Foundation Chair in Respiratory Research. Asthma UK funded the GASP initiative (AUK-PG-2013-188). This work was part funded by the NIHR Leicester Respiratory Biomedical Centre. AS is supported by the NIHR Manchester Biomedical Research Centre. MAAS was supported by the Asthma UK grants (no. 301, 1995–1998; no. 362, 1998–2001; no. 01/012, 2001–2004; no. 04/014, 2004–2007; BMA James Trust, 2005; The JP Moul-ton Charitable Foundation, 2004–current; The North west Lung Centre Charity, 1997-current; the Medical Research Council (MRC) G0601361, 2007–2012; MR/K002449/1, 2013–2014; and MR/L012693/1, 2014–2018). The Lifelines Biobank initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, UMCG (the Netherlands), University Groningen, and the Northern Provinces of the Netherlands. This study was also supported by a Lung Foundation of the Netherlands Dutch Lung Foundation (grant nos. AF 95.05, AF 98.48, and AF3.2.09. 081JU), the UMCG, Dutch TerMeulen Fund, and the Ubbo Emmius Fund (University of Groningen). The authors would like to thank Carl Nelson of Nottingham Trent University for his kind donation of HEK–NF-κB–SEAP reporter cells. The authors also wish to acknowledge the services of the Lifelines Cohort Study, the contributing research centers delivering data to Lifelines, and all the study participants.
PY - 2010/9
Y1 - 2010/9
N2 - Cerebrovascular disease appears to have implications on rheumatic diseases, including gout. Accumulating evidence suggests that hemiparesis exerts a protective effect against gout via the down-regulation of mechanical and neural modulators of inflammation in neurologically impaired extremities. We present 2 divergent cases of unilateral gout following cerebrovascular events. One patient with a hemorrhagic stroke developed polyarticular gout only on the ipsilateral side to his hemiparesis, while another patient with basilar artery thrombosis and locked-in syndrome suffered a polyarticular gout flare only on the side that had regained limited function. As suggested by these cases, the effect of hemiparesis on gout is complex. Further insight into the interplay between gouty flares and hemiparesis may lead to novel therapeutic strategies for gout.
AB - Cerebrovascular disease appears to have implications on rheumatic diseases, including gout. Accumulating evidence suggests that hemiparesis exerts a protective effect against gout via the down-regulation of mechanical and neural modulators of inflammation in neurologically impaired extremities. We present 2 divergent cases of unilateral gout following cerebrovascular events. One patient with a hemorrhagic stroke developed polyarticular gout only on the ipsilateral side to his hemiparesis, while another patient with basilar artery thrombosis and locked-in syndrome suffered a polyarticular gout flare only on the side that had regained limited function. As suggested by these cases, the effect of hemiparesis on gout is complex. Further insight into the interplay between gouty flares and hemiparesis may lead to novel therapeutic strategies for gout.
UR - http://www.scopus.com/inward/record.url?scp=77956446599&partnerID=8YFLogxK
U2 - 10.1097/RHU.0b013e3181eed855
DO - 10.1097/RHU.0b013e3181eed855
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C2 - 20689442
AN - SCOPUS:77956446599
SN - 1076-1608
VL - 16
SP - 293
EP - 294
JO - Journal of Clinical Rheumatology
JF - Journal of Clinical Rheumatology
IS - 6
ER -
