When Gout Is in Doubt: A Curious Case of Lupus Nephritis

The association between systemic lupus erythematosus (SLE) and tophaceous gout is rarely documented. It can remain unnoticed if gout peculiarly lacks clinical symptoms. This may be attributed to treating SLE with immunosuppressive agents and steroids, which can mask the inflammation caused by gout. In this case report, we will discuss the case of a 35-year-old female from an indigenous Asian ethnic group called the Hmong community living in Fresno, California. She was diagnosed with lupus nephritis (LN) and was incidentally found to have tophi in the kidney with no gout symptoms clinically. This meant that persistent unchecked hyperuricemia could have been addressed if found earlier. This case study highlights potential genetic implications within the Hmong ethnicity in understanding gout when associated with SLE.