A case of secondary amyloidosis associated with gout

• Published in: Nihon Jinzo Gakkai shi Vol. 27; no. 8; pp. 1201 - 1207
• Main Authors: HIRABAYASHI, TOSHIAKI, AZUMA, MASAYUKI, IHARA, HAJIME, IWASAKI, TORU, YORIFUJI, RYOICHI, INAGAKI, OUSHI, MORI, HIDETARO, INOUE, SEISHI, FUJITA, YOSHIKAZUX, SAKAI, RUMI
• Format: Journal Article
• Language: Japanese
• Published: Japan Japanese Society of Nephrology 01.08.1985
• Subjects: amyloidosis; Amyloidosis - etiology; chronic renal failure; gout; Gout - complications; hemodialysis; Humans; Kidney Failure, Chronic - complications; Male; Middle Aged
• ISSN: 0385-2385; 1884-0728
• DOI: 10.14842/jpnjnephrol1959.27.1201

A 59 Year-old man was admitted to hospital because of oliguria and an attack of gout. During the past 16 years, he has suffered from recurrent attacks of gout. He never received any drugs except for colchicine and antiphlogistics. Apart from these attacks, he had not suffered from chronic infections and inflammatory diseases. The physical examination showed multiple tophi on extremities. Laboratory studies revealed a hemoglobin of 7.7 g/dl, hematocrit of 23.1 %, and a white blood count of 10, 300/ mm3. The serum uric acid was 9.9 mg/dl, blood urea nitrogen 119 mg/dl, serum creatinine 13.1 mg/dl, total serum protein 6.2 g/dl, and base excess -11 mEg/l. The erythrocyte sedimentation rate was 155 mm/hour. Therefore, hemodialysis was started 3 times a week, and antibiotics and human serum albumin were received. After 18 days, he was admitted to because of paralytic ileus and hypotension. After 6 days, he died from pulmonary edema. The autopsy showed multiple tophi on extremities and right auricle, gouty nephropathy of both kidneys, systemic amyloidosis including various organs with kidneys, hydrothoraces, and hypertrophy of heart. Amyloid protein of renal glomeruli was amyloid A protein. Finally, we diagnosed this case a secondary amyloidosis associated with polyarticular gout. So far as we know, there has been few reports in the world on the secondary amyloidosis due to gout. But, many other chronic inflammatory arthritis includind rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondilitis, and psoriatic arthritis, often occur systemic amyloidosis. We discussed about the possible combination of gout with systemic amylodosis.