Tophaceous gout in a patient with sickle cell-thalassemia: case report and review of the literature

✍ Scribed by Robert D. Leff; Marlene A. Aldo-Benson; Rose Spitz Fife

• Publisher: John Wiley and Sons
• Year: 1983
• Tongue: English
• Weight: 193 KB
• Volume: 26
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780260718

✦ Synopsis

Secondary gout is a recognized complication of several hematologic disorders, including many chronic hemolytic anemias characterized by increased purine metabolism. However, gouty arthritis has been described in only a few patients with hemoglobinopathies, and the identification of typical monosodium urate crystals in synovial fluid or in tophi from these patients has rarely been reported (1-5).

This communication describes a case of biopsyproven tophaceous gout in a patient with sickle cellthalassemia.

Case report. A 37-year-old black man with sickle cell-thalassemia was admitted for excisional biopsy of nodules from his left olecranon bursa and right earlobe. Approximately 7 years earlier, he had noted erythema, tenderness, and swelling of his right ankle and, after an arthrocentesis, was told he had gout. He had several flares of arthritis each year, involving at different times the metatarsophalangeal joints, knees, shoulders, elbows, rnetacarpophalangeal joints, and proximal interphalangeal joints. He took colchicine intermittently, but no hypouricemic agents. The patient had no history of alcohol ingestion, hypertension, or lead exposure. His family history was positive for sickle cell anemia and negative for gout.