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April 1980

Sudden Appearance of Tophaceous Gout in a Woman With Chronic Renal Failure

Arch Intern Med. 1980;140(4):582-583. doi:10.1001/archinte.1980.00330160142055

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To the Editor.  —Tophaceous gout appeared in a 34-year-old patient with a history of chronic renal failure of at least two decades' duration. All the symptoms and signs resolved after treatment with allopurinol. The occurrence of tophaceous gout in a female in the reproductive age group must be distinctly rare. It is possible that the unusually protracted course of the chronic renal failure and, presumably, the resultant hyperuricemia combined to produce this rare clinical manifestation.

Report of a Case.  —A 34-year-old woman was admitted to the hospital because of arthritis in her right foot and nodules on the finger pads. At the age of 13 years, she had acute glomerulonephritis. Five years later, she was hospitalized because of hypertension. The serum urea level then was 77 mg/dL, and a tentative diagnosis of chronic glomerulonephritis was made. At the age of 20 years, the serum uric acid level was 6 mg/dL.

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