Immobilization hypercalcemia-associated acute renal failure in a patient with chronic tophaceous gout

Abstract

We report a case of patient suffering from chronic tophaceous gout of multiple, large joints. The patient was diagnosed with acute renal failure by immobilization hypercalcemia and successfully treated with fluid and diuretics, rehabilitative exercises, and bisphosphonate, without further recurrence during six months follow-up. Acute renal failure can occur in the patient with gout as an acute uric acid nephropathy due to the deposition of uric acid within the renal tubules. Immobilization hypercalcemia is a rare cause of acute renal failure in patients with immobilization due to the limitation of motion. We suggest that immobilization can be a possible cause of hypercalcemia-induced acute renal failure in patients with chronic tophaceous gout involving multiple large joints, and clinical alertness is needed to avoid unnecessary evaluations and life-threatening complications. © 2009 Informa UK, Ltd.