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“From father to son”: Early onset gout in Guidobaldo I da Montefeltro, Duke of Urbino (1472–1508)

  • R. Bianucci
    Correspondence
    Corresponding author at: Department of Public Health and Paediatric Sciences, Legal Medicine Section, University of Turin, Corso Galileo Galilei, 22, 10126 Turin, Italy. Fax: +39 0116705934.
    Affiliations
    Department of Public Health and Paediatric, Legal Medicine Section, University of Turin, Italy

    UMR 7268, Laboratoire d'Anthropologie Bio-culturelle, Droit, Etique & Santé (Adés), Faculté de Médecine de Marseille, France
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  • A. Perciaccante
    Affiliations
    Department of Medicine, “San Giovanni di Dio” Hospital, Gorizia, Italy
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  • O. Appenzeller
    Affiliations
    New Mexico Health Enhancement and Marathon Clinics Research Foundation, Albuquerque, NM, USA
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Published:August 04, 2016DOI:https://doi.org/10.1016/j.ejim.2016.07.018
      Named the “Disease of the Kings”, gout (podagra) is one of the oldest diseases reported in medical literature and has modern clinical relevance due to its impact on morbidity and premature mortality [
      • Roddy E.
      • Mallen C.D.
      • Doherty M.
      Gout.
      ,
      • Kuo C.F.
      • Grainge M.J.
      • See L.C.
      • Yu K.
      • Luo S.F.
      • Valdes A.M.
      • et al.
      Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan.
      ]. The peak age of onset of gout is in the fourth to sixth decade of life with a strong male predilection [
      • Zhu Y.
      • Pandya B.J.
      • Choi H.K.
      Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008.
      ]. The risk of gout is higher in people with a family history; however the existence of many risk factors (such as male gender, increasing age, obesity, chronic renal impairment, hypertension (metabolic syndrome) and certain diets with high purine i.e. red meat, seafood, and liver and alcohol content [
      • Kuo C.F.
      • Grainge M.J.
      • See L.C.
      • Yu K.
      • Luo S.F.
      • Valdes A.M.
      • et al.
      Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan.
      ]) shows that environmental factors also play an important role [
      • Roddy E.
      • Mallen C.D.
      • Doherty M.
      Gout.
      ,
      • Kuo C.F.
      • Grainge M.J.
      • See L.C.
      • Yu K.
      • Luo S.F.
      • Valdes A.M.
      • et al.
      Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan.
      ]. Heritability of hyperuricemia is the main driver for the deposition of urate crystals in and around joints and tendons. Untreated, continuing crystal deposition can result in irreversible joint damage [
      • Roddy E.
      • Mallen C.D.
      • Doherty M.
      Gout.
      ,
      • Kuo C.F.
      • Grainge M.J.
      • See L.C.
      • Yu K.
      • Luo S.F.
      • Valdes A.M.
      • et al.
      Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan.
      ]. Urate crystal deposition (tophus) also occurs in soft tissues after about a decade of suffering [
      • Roddy E.
      • Mallen C.D.
      • Doherty M.
      Gout.
      ,
      • Kuo C.F.
      • Grainge M.J.
      • See L.C.
      • Yu K.
      • Luo S.F.
      • Valdes A.M.
      • et al.
      Familial aggregation of gout and relative genetic and environmental contributions: a nationwide population study in Taiwan.
      ].

      Keywords

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