Gouty Tophi: Two Case Report.
Gouty tophi represent a symptom of chronic form of gout resulting from accumulation of
monosodium urate crystals in tissues, which is the most prevalent form of inflammatory arthritis.
The tophus represents a granulomatous inflammatory response to monosodium urate crystals.
Women are less likely to have gout than men but they develop it in the postmenopausal
years and have comorbidities such renal disease, diabetes or concomitant use of diuretics more
common as compared with men.
We present two cases of gouty tophi. A 66-year-old man presented with an intense joint pain and
deformities on his toes. Furthermore, the patient had an additional lump in his left elbow.
He had personal history of hypercholesterolemia and hypertriglyceridemia.
He had elevated levels of uric acid a year ago but in treatment with allopurinol the levels
had descended to normality; uric acid 3.33 mg/dL Histological study was consistent with gouty tophi.
He was referred to rheumatologist
A 84-year-old man with multiple co-morbidities such as dyslipidemia, hypertension and hyperuricemia,
presented to us with multiple soft tissue masses over several metacarpals associated
with severe joint deformities.
He had not been treated regularly for gout. Laboratory tests included urea 78.8 mg/dL (normal range 17.1-49.2), uric acid levels of 9.98 mg/dL (normal range 3.5-7.2), creatinine 1.63 mg/dL (normal range 0.8-1.3). We establish diagnosis of gouty tophi and referred to his physician for appropriate treatment.
The patient started therapy with allopurinoll 100 mg daily with resolution of symptoms.
The prevalence of gout and hyperuricemia is on the rise in developing countries probably
related to population aging, alcohol intake, hypertension, obesity, metabolic syndrome
and use of diuretics. The prevalence increases with age.
Dermatol Open J. 2017; 2(1): 16-17. doi: 10.17140/DRMTOJ-2-122
