Comprehensive Nursing Management of Non-Tophaceous Gout in a 30-Year-Old Male with Vitamin D Deficiency: A Case Study
DOI:
https://doi.org/10.55677/IJCSMR/V4I8-03/2024Keywords:
Gout, nurse-led management, vitamin D deficiencyAbstract
Background: Gout, an inflammatory arthritis linked to hyperuricemia, primarily affects older people. This study highlights the overlooked impact of vitamin D deficiency on urate-lowering therapy in younger patients diagnosed with gout.
Objective: The objective of this study is to discuss comprehensive nursing management of a 30-year-old patient with vitamin D deficiency who was diagnosed with non-tophaceous gout in primary care.
Methods: The case presentation involves a 30-year-old patient who presented to the GP with symptoms of gout. An x-ray ruled out a fracture, which was the patient's primary suspicion after slipping downstairs drunk. Serum uric acid levels were highly elevated, and he was prescribed urate-lowering therapy comprising allopurinol, prednisolone, and naproxen. The patient's symptoms did not improve over time, as flare-ups were frequent, even in the absence of a restricted diet and alcohol intake. On follow-up, the nurse discovered the patient's vitamin D deficiency. The patient was prescribed vitamin D supplements alongside urate-lowering therapy.
Results: Following combined treatment with vitamin D supplements and urate-lowering therapy, serum uric acid levels reduced significantly, achieving <6 mg/dL. During the eight-month follow-up, the patient only experienced a minor episode of a flare once.
Conclusion: This case study demonstrates the importance of assessing vitamin D deficiency in gout patients, especially the younger ones. Addressing vitamin D deficiency, if present, together with the administration of standard urate-lowering therapy, can improve outcomes and the frequency of flare-ups in gout patients.
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