Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
CASE REPORTS
Multiple Gouty Tophi with Bone Erosion and Destruction: A Report of an Early-onset Case in an Obese Patient
Reiko D HayashiMasaya YamaokaHitoshi NishizawaShiro FukudaYuya FujishimaTakekazu KimuraJyunji KozawaShunbun KitaTaka-aki MatsuokaMichio OtsukiAkihisa ImagawaKimiyoshi IchidaAtsuo TaniguchiNorikazu MaedaTohru FunahashiIichiro Shimomura
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JOURNALS OPEN ACCESS

2017 Volume 56 Issue 9 Pages 1071-1077

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Abstract

A 27 year-old severely obese man (BMI, 35.1) had hyperuricemia and multiple gouty tophi with bone erosion and destruction, resulting in gait disturbance for 6 years after the early onset of gout at 21 years of age. His hyperuricemia was associated with hyperinsulinemia in obesity and a genetic variant of the ABCG2 gene. In addition, multiple gouty tophi with bone erosion and destruction might have been caused by hypoadiponectinemia and the elevation of the patient' s pro-inflammatory cytokine (IL-1β) level with the accumulation of visceral fat. In this case, bone and Ga-67 scintigraphy were useful for detecting the location and magnitude of gouty tophi.

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© 2017 by The Japanese Society of Internal Medicine
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