title: Histopathologic examination of conjunctival tophi in gouty arthritis.
abstract: OBJECTIVE
  To report a case of conjunctival tophi in a 59-year-old woman with gouty arthritis.
  
  
  METHODS
  Observational case report.
  
  
  METHODS
  A 59-year-old woman with a 25-year history of severe gouty arthritis presented with bilateral chalky white conjunctival deposits. Conjunctival biopsies were obtained, and light and electron microscopy studies were performed.
  
  
  RESULTS
  Light microscopy confirmed multiple gouty tophi. Transmission electron microscopy revealed intracytoplasmic crystalline deposits within histiocytes. Extracellular aggregates of the crystalline deposits were enclosed by membranous material.
  
  
  CONCLUSIONS
  Conjunctival crystals may aid in identifying undiagnosed patients. In addition to conjunctival tophi, patients may also have uveitis, corneal crystals, and band keratopathy.
authors.affiliation: Department of Ophthalmology, Emory University School of Medicine, and Emory Eye Center, 1365B Clifton Road NE, Atlanta, GA 30322, USA.
authors.forename: Wayne R
authors.initials: WR
authors.lastname: Lo
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Broocker
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
mesh_terms: D015210:Arthritis, Gouty / Q000473:pathology*; D001706:Biopsy; D003229:Conjunctival Diseases / Q000473:pathology*; D004804:Eosinophils / Q000648:ultrastructure; D005260:Female; D015743:Giant Cells, Foreign-Body / Q000648:ultrastructure; D006644:Histiocytes / Q000378:metabolism / Q000648:ultrastructure; D006801:Humans; D002479:Inclusion Bodies / Q000378:metabolism / Q000648:ultrastructure*; D008875:Middle Aged; D014527:Uric Acid / Q000378:metabolism
chemical_list: D014527:Uric Acid