Skoči na glavni sadržaj

Ostalo

Chronic, Long-Lasting, and Untreated Gout with Concomitant Dilated Cardiomyopathy and Exceptionally Vast Anasarca: Case Report

Petra Šulentić
Branko Bečejac
Ozren Vinter
Milan Vrkljan


Puni tekst: engleski pdf 120 Kb

str. 427-429

preuzimanja: 752

citiraj


Sažetak

Gout is the most common type of inflammatory arthritis in man caused by deposition of urate crystals into the joints as the result of elevated serum urate levels. A case of a 59-year-old patient with untreated, long-lasting gout and clinical manifestation of decompensated global dilated cardiomyopathy is presented. Examination revealed generalized pitting edema extending from both lower extremities to the sacrum, abdominal, and thoracic wall, with scrotal swelling and upper extremity involvement, an exceptionally vast generalized edema, i.e. anasarca. Proximal and distal interphalangeal joints of the hands and feet were swollen and deformed, with marked yellow tophi nodules. Laboratory studies revealed high serum uric acid concentration (546 μmol/L), decreased creatinine clearance (0.8 mL/s) and albumin concentration (27.4 g/L), as well as increased total urine protein mass (0.35 g/24 h). X-rays of the affected feet and fists showed punched-out lesions of the subchondral bone with overhanging bony margins in the first metatarsophalangeal, proximal, and distal interphalangeal joints of both hands. The extreme clinical presentation resolved upon intravenous administration of diuretics and pleurocentesis, followed by oral medications including furosemide, angiotensin-converting enzyme inhibitor, spironolactone and digoxin. Since serum urate level has been identified as an independent risk factor for the development of ischemic heart and chronic kidney disease, regulation of urate concentration is necessary, especially in patients diagnosed with gout.

Ključne riječi

Gout; Arthritis, gouty; Cardiomyopathy, dilated

Hrčak ID:

84204

URI

https://hrcak.srce.hr/84204

Datum izdavanja:

8.9.2011.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.106 *