Original article | Volume 32, Article 125, 15 Mar 2019 | 10.11604/pamj.2019.32.125.16062

When do you not listen to your doctor

Catia Aguiar Cabral, António Grilo Novais

Corresponding author: Catia Aguiar Cabral, Internal Medicine Service, Centro Hospitalar Tondela-Viseu, Viseu, Portugal

Received: 16 May 2018 - Accepted: 07 Nov 2018 - Published: 15 Mar 2019

Domain: Internal medicine,Rheumatologist

Keywords: Gout, diet, medication

©Catia Aguiar Cabral et al. Pan African Medical Journal (ISSN: 1937-8688). This is an Open Access article distributed under the terms of the Creative Commons Attribution International 4.0 License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Cite this article: Catia Aguiar Cabral et al. When do you not listen to your doctor. Pan African Medical Journal. 2019;32:125. [doi: 10.11604/pamj.2019.32.125.16062]

Available online at: https://www.panafrican-med-journal.com/content/article/32/125/full

Home | Volume 32 | Article number 125

Original article

When do you not listen to your doctor

When do you not listen to your doctor

Catia Aguiar Cabral1,&, António Grilo Novais1

 

1Internal Medicine Service, Centro Hospitalar Tondela-Viseu, Viseu, Portugal

 

 

&Corresponding author
Catia Aguiar Cabral, Internal Medicine Service, Centro Hospitalar Tondela-Viseu, Viseu, Portugal

 

 

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Gout is a disease caused by an inflammatory response to crystals of sodium monourate, which occurs in people with elevated uric acid levels. There are acute and chronic forms. Acute forms arise as sudden, self-limiting bouts of arthritis (swelling, flushing, pain and heat of a joint), while chronic forms result in the deposition of crystal aggregates in and around the joints, with progressive joint destruction. In addition to joint manifestations, uric gout has renal manifestations (kidney stones and renal insufficiency) and metabolic manifestations (hypertension, elevated triglycerides). Patients are often obese, have high alcohol consumption and insulin resistance. It is a very painful and disabling illness. Gout is more common in men and usually begins in the 40's and 60's. Analytically the patient had uric acid values of 10.2 mg/dL (2.0-7.0 mg/dL) despite being daily medicated with alopurinol 300mg for more than 5 years. It has an abnormality of fasting glycemia and triglycerides of 305 mg/dl. However it maintains consumptions of alcohol and a diet rich in meat, seafood and fats. He did not diet to lose weight and sometimes he does not take the medication (alopurinol). He already shows involvement and destruction of the joints and deformation on the feet and the hand that currently prevent him from fulfilling the necessary safety norms in his profession.

 

 

Figure 1: (A,B) this patient was advised several times by the doctor that he had to change his diet but he did not fulfill the recommendations

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Original article

When do you not listen to your doctor

Original article

When do you not listen to your doctor

Original article

When do you not listen to your doctor

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Key words

Gout

Diet

Medication

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When do you not listen to your doctor