Document Detail


Successful treatment with rasburicase of a tophaceous gout in a patient allergic to allopurinol.
MedLine Citation:
PMID:  16932713     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A 56-year-old white woman was referred to our institution with a 16-month history of severe, gouty, recurrent, acute polyarthritis involving the finger joints. She also had numerous small subcutaneous tophi in her hands. The patient was intolerant to allopurinol and had mild renal insufficiency attributed to uric-acid nephrolithiasis and interstitial nephropathy. INVESTIGATIONS: Physical examination, laboratory testing, X-rays of the hands, feet and pelvis, CT of the pelvis, microscopic analysis of an aspirate from a finger tophus. DIAGNOSIS: Tophaceous gout associated with urate nephropathy in a patient intolerant to allopurinol. MANAGEMENT: Acute polyarthritis was successfully managed by intravenous bolus methylprednisolone combined with codeine, diclofenac and low-dose colchicine. Rasburicase infusions combined with fenofibrate and sodium bicarbonate achieved to maintain serum acid uric below 360 micromol/l.
Authors:
Pascal Richette; Thomas Bardin
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Nature clinical practice. Rheumatology     Volume:  2     ISSN:  1745-8382     ISO Abbreviation:  -     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-08-25     Completed Date:  2006-09-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101261802     Medline TA:  Nat Clin Pract Rheumatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  338-42; quiz 343     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Centre Viggo Petersen, Lariboisiere Hospital, University Paris VII, France. pascal.richette@lrb.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Allopurinol / adverse effects*
Arthritis, Gouty / diagnosis,  drug therapy*
Diagnosis, Differential
Female
Finger Joint
Gout Suppressants / adverse effects*
Humans
Hypersensitivity / etiology*
Middle Aged
Recombinant Proteins / therapeutic use*
Severity of Illness Index
Urate Oxidase / therapeutic use*
Chemical
Reg. No./Substance:
0/Gout Suppressants; 0/Recombinant Proteins; 315-30-0/Allopurinol; EC 1.7.3.3/Urate Oxidase; EC 1.7.3.3./rasburicase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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