Multiple Gouty Tophi with Bone Erosion and Destruction: A Report of an Early-onset Case in an Obese Patient

A 27 year-old severely obese man (BMI, 35.1) had hyperuricemia and multiple gouty tophi with bone erosion and destruction, resulting in gait disturbance for 6 years after the early onset of gout at 21 years of age. His hyperuricemia was associated with hyperinsulinemia in obesity and a genetic varia...

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Detalles Bibliográficos
Autores principales: D Hayashi, Reiko, Yamaoka, Masaya, Nishizawa, Hitoshi, Fukuda, Shiro, Fujishima, Yuya, Kimura, Takekazu, Kozawa, Jyunji, Kita, Shunbun, Matsuoka, Taka-aki, Otsuki, Michio, Imagawa, Akihisa, Ichida, Kimiyoshi, Taniguchi, Atsuo, Maeda, Norikazu, Funahashi, Tohru, Shimomura, Iichiro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478570/
https://www.ncbi.nlm.nih.gov/pubmed/28458315
http://dx.doi.org/10.2169/internalmedicine.56.7923
Descripción
Sumario:A 27 year-old severely obese man (BMI, 35.1) had hyperuricemia and multiple gouty tophi with bone erosion and destruction, resulting in gait disturbance for 6 years after the early onset of gout at 21 years of age. His hyperuricemia was associated with hyperinsulinemia in obesity and a genetic variant of the ABCG2 gene. In addition, multiple gouty tophi with bone erosion and destruction might have been caused by hypoadiponectinemia and the elevation of the patient’s pro-inflammatory cytokine (IL-1β) level with the accumulation of visceral fat. In this case, bone and Ga-67 scintigraphy were useful for detecting the location and magnitude of gouty tophi.

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