A case of secondary gout associated with myelofibrosis in a 70-year-old male was reported.
At the age of 50 he was noted to be plethoric; at age 54 he was afflicted with gouty arthritis and came to our clinic where he was treated with colchicine with a good response. During his first admission at the age of 56, laboratory studies revealed RBC 980×10
4, WBC 16,200, Plt 63.8×10
4, serum uric acid 10.8mg/d
l and he had no other disease which would lead to secondary polycythemia. Then he was diagnosed as having secondary gout associated with polycythemia vera. After discharge he was treated with
32P and venesection; however his blood count showed no improvement, and he suffered from gouty attacks from one to five times a year.
At 68 of his age his blood pictures changed to those of anemia.
During his second admission at age 70, he was diagnosed as having myelofibrosis, on the bases of splenomegaly, leukoerythroblastic anemia, ineffective and extramedullary erythropoiesis by ferrokinetic study, no aspirate on bone marrow puncture, and myelofibrosis by bone marrow biopsy. His blood uric acid level was 9.6mg/d
l.
During the entire period, even after he became anemic, his blood uric acid levels had been constantly high, associated with gouty arthritis.
This is the 4th case of myelofibrosis with anemia following polycythemia vera in Japan and the first case of secondary gout associated with myelofibrosis there.
View full abstract