Friday, March 23, 2018

Psoriatic Arthritis and Gout?

Someone recently suggested that I look into the possibility of having psoriatic arthritis.  My first thought was that I do not have psoriasis, but I looked into it anyway.

I've had an ugly toe since high school, but thought it was a lifted nail bed from running cross country.  There's also a spot on my scalp that feels more flakey to the touch and has not gone away.  Never thought much about it.  Only one toe is "ugly" but those others so far are unaffected.  There is some genetic susceptibility to developing psoriasis.

rs1265181: CG, MAF = 0.101. Increased risk for developing psoriasis
rs1265159: POU5F1, AG, MAF, A = 0.1569. 5x risk for developing psoriasis

There also seems to be an association with psoriasis and psoriatic arthritis with the development of gout (read here).  I currently do not have high uric acid but had what appeared to be a gout attack in 2014.  I also have a lot of genetic susceptibility for developing gout due to the ABCG2 gene.  One interesting statement is, "For men and women with both psoriasis and psoriatic arthritis, the risk of developing gout was nearly five times greater compared to participants with no psoriasis or psoriatic arthritis."  I suppose having both psoriatic arthritis, an autoimmune disease, and gout, a crystal induced arthritis, is not so far-fetched after all.  Since my rheumatoid factor was negative, psoriatic arthritis is a possible cause for the polyarticular joint pain despite keeping my uric acid within the normal range.  PsA may fit the bill because:
  • Lifted toenail, dry patch in scalp
  • Bursitis in the right hip preceded the gout attack
  • Low white blood cell count, which could be due to an inflammatory or autoimmune condition
  • Rheumatoid factor was negative
  • Genetic susceptibility for gout and psoriasis
  • Was 31 when I develop polyarthritis
  • Had gastrointestinal issues at one point
  • Had a gout attack
  • I still have more joints getting affected even after controlling my uric acid level
  • Started having persistent lower back pain
  • Could cause symmetrical or asymmetrical joint pain


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