A case of chronic tophaceous with a continuous polyarthritis and joint deformity caused by uncontrolled hyperuricemia

Abstract

A 56-year-old woman was admitted to our hospital in April 2007 due to a history of polyarthralgia. In 1999, She had been diagnosed as having gout by monoarthritis of the first metatarsophalangeal joint. She was treated with only cholchine. Subsequently she repeatedly got acute attack once a year. In 2006, episodic monoarthritis became to be continuous polyarthritis. Laboratory examination at admission showed remarkable hyperuricemia. At 3 day after hospitalization, she experienced acute attack and high fever. Diagnosis of chronic gout was confirmed by the identification of monosodium urate crystals in the synovial fluid. Her symptom improved by a treatment with dexamethasone 4 mg/day i.m. and cholchine, and did not experience acute attack for 5 months. We suggest that prophylactic administration of cholchine is beneficial in refractory chronic gout patient.