Rheumato, Volume 2, Issue 2 (June 2022) – 2 articles

From ancient times to the present day, gout has been associated in the popular and scientific literature with wealthy men who overindulge in fancy foods, fine wine, and debauchery. Curiously, amongst diseases, gout was thought to be good, a malady to be accepted because of otherwise beneficial effects on health, and longevity. This narrative review critically examines the history of these associations and explores in detail the pathogenic factors contributing to development of gout prior to the 20th century. While lead toxicity has been previously implicated with wine, the specific association of gout and fine wine can be attributed to lead complexes in products such as sapa, a grape extract used to sweeten wine, in addition to lead nanoparticles leached from crystal glassware and lead glazed dinner plates. The health benefits of gout can be attributed to lead complexes in fine wine and lead nanoparticles from glazed dinnerware. These compounds have excellent antibacterial properties, thereby inhibiting the presence of pathogenic bacteria in foodstuffs. Probing the association of gout and fine wine provides a very well documented example of how the pathogenesis of disease becomes better understood with the passage of time and continuing, persistent scientific enquiry. Full article

Kawasaki disease (KD) is an acute febrile illness, principally affecting children under 5 years, due to a systemic vasculitis of obscure etiology. In 2017, the American Heart Association published the diagnostic criteria for KD in their scientific statement. Following the emergence of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), there has been an upsurge in the reports of KD as well as a novel multisystem inflammatory syndrome in children (MIS-C). Clinical manifestations of MIS-C are similar to KD and toxic-shock syndrome, making the clinical diagnosis challenging. Studies have shown promising results to differentiate KD from MIS-C using epidemiological, clinical, hematological, and immunological characteristics. Serological evidence may be negative in these patients at presentation, as MIS-C is a late manifestation of SARS-CoV-2 exposure. However, diagnosis and management challenges currently exist due to a gap in knowledge of these conditions. Further research is warranted to identify diagnostic tools to differentiate KD and MIS-C and optimize the therapeutic strategy, reducing morbidity and mortality related to these phenotypically similar diseases. This review aims to highlight the best available evidence for managing children with KD and MIS-C in the background of the ongoing COVID-19 pandemic. Full article