Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma
The prevalence of gout is increasing with increased life expectancy. Approximately half of the patients with gout have some degree of renal impairment. If both conditions persistently coexist, and in severe tophaceous gout, in particular, treatment has been difficult. We here report on the case of a...
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Wiley
2011-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2011/397646 |
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| author | Anne-Kathrin Tausche Carsten Wunderlich Martin Aringer |
| author_facet | Anne-Kathrin Tausche Carsten Wunderlich Martin Aringer |
| author_sort | Anne-Kathrin Tausche |
| collection | DOAJ |
| description | The prevalence of gout is increasing with increased life expectancy. Approximately half of the patients with gout have some degree of renal impairment. If both conditions persistently coexist, and in severe tophaceous gout, in particular, treatment has been difficult. We here report on the case of an 87-year-old woman, who had been suffering from recurrent gouty arthritis over 4 years. Monthly polyarthritis attacks were accompanied by subcutaneous tophi. Serum uric acid levels were constantly above 600 μmol/L (10 mg/dL). Allopurinol was no option because of intolerance, while benzbromarone was ineffective because of renal impairment. Therefore, the novel xanthin oxidase inhibitor febuxostat was started, achieving rapid control of serum urate levels (<360 μmol/L). After initial worsening of inflammation in the first weeks, gouty attacks stopped and all tophi resolved within the following 10 months. Renal function remained stable. |
| format | Article |
| id | doaj-art-641e712c6fc64c4bada5d54a299ebdd6 |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2011-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-641e712c6fc64c4bada5d54a299ebdd62025-02-03T01:11:13ZengWileyCase Reports in Medicine1687-96271687-96352011-01-01201110.1155/2011/397646397646Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic DilemmaAnne-Kathrin Tausche0Carsten Wunderlich1Martin Aringer2Section of Rheumatology, Department of Internal Medicine, University Clinic “Carl Gustav Carus” of the Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden, GermanyDepartment of Cardiology and Intensive Care, Heart Centre Dresden, University Hospital of the Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden, GermanySection of Rheumatology, Department of Internal Medicine, University Clinic “Carl Gustav Carus” of the Technical University of Dresden, Fetscherstrasse 74, 01307 Dresden, GermanyThe prevalence of gout is increasing with increased life expectancy. Approximately half of the patients with gout have some degree of renal impairment. If both conditions persistently coexist, and in severe tophaceous gout, in particular, treatment has been difficult. We here report on the case of an 87-year-old woman, who had been suffering from recurrent gouty arthritis over 4 years. Monthly polyarthritis attacks were accompanied by subcutaneous tophi. Serum uric acid levels were constantly above 600 μmol/L (10 mg/dL). Allopurinol was no option because of intolerance, while benzbromarone was ineffective because of renal impairment. Therefore, the novel xanthin oxidase inhibitor febuxostat was started, achieving rapid control of serum urate levels (<360 μmol/L). After initial worsening of inflammation in the first weeks, gouty attacks stopped and all tophi resolved within the following 10 months. Renal function remained stable.http://dx.doi.org/10.1155/2011/397646 |
| spellingShingle | Anne-Kathrin Tausche Carsten Wunderlich Martin Aringer Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma Case Reports in Medicine |
| title | Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma |
| title_full | Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma |
| title_fullStr | Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma |
| title_full_unstemmed | Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma |
| title_short | Tophaceous Gout and Renal Insufficiency: A New Solution for an Old Therapeutic Dilemma |
| title_sort | tophaceous gout and renal insufficiency a new solution for an old therapeutic dilemma |
| url | http://dx.doi.org/10.1155/2011/397646 |
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