Ulcerated tophaceous gout. (3rd August 2015)

• Record Type: Journal Article
• Authors: Filanovsky, Michelle Gita; Sukhdeo, Kumar; McNamara, Megan Cunnane
• Is Part Of: BMJ case reports. Volume 2015
• Publication Date: 2015-08-03
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2015-210707
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Gout is an inflammatory arthritis characterised by hyperuricemia, which, if poorly controlled, can lead to the development of tophi. We report the case of a 60-year-old Caucasian man with poorly controlled polyarticular tophaceous gout with multiple comorbidities (including renal failure) who presented with tophaceous ulcers of the upper extremity. These ulcers caused extreme pain, requiring chronic opiate medications, and were associated with decreased sensation and reduced ability to move the extremity. His hospital course was complicated by acute kidney injury, haemolytic anaemia and Clostridium difficile infection. He required 1 month of antibiotics and intensive wound care for his ulcers. This case highlights the diagnosis, natural history and management of an unusual complication of hyperuricemia.