title: [Combination of ankylosing spondylitis with dermatomyositis and atypical gout (isolated gout kidney)].
abstract: In a 58-year-old man with the clinical and radiological signs of definite ankylosing spondylitis in its final stages, HLA B 27 positive, an onset of dermatomyositis was observed with characteristic clinical, histological, and pathological findings, and with high titers of ANA. It had been discovered years before that a gouty kidney with pyelonephritis accompanied the advanced ankylosing spondylitis. On the basis of these findings a triple association of etiologically different diseases could be diagnosed. After treatment with cortisone, allopurinol, and azathioprine appeared an acute and no longer controllable panmyelophthisis. That a malignant tumor could have caused the dermatomyositis was excluded by autopsy. Diagnostic questions concerning the gouty kidney as well as factors explaining the acute and deadly progress of a panmyelophthisis after the administration of a rather mild immunosuppressive agent are discussed.
mesh_terms: D003882:Dermatomyositis / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006073:Gout / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008875:Middle Aged; D011704:Pyelonephritis / Q000150:complications* / Q000175:diagnosis; D013167:Spondylitis, Ankylosing / Q000150:complications* / Q000175:diagnosis
vernacular_title: Kombination einer Spondylitis ankylosans (Sp.a.) mit Dermatomyositis und atypischer Gicht (isolierte Gichtniere).