title: [Gout as an unusual cause of pelvic pain].
abstract: An 89-year-old woman was admitted for high fever and debilitating pelvic pain, notably in the pubic area. Physical examination revealed multiple gouty tophi in her hands and feet. Laboratory investigation revealed severe leukocytosis and a sharply increased C-reactive protein level. The patient was treated with broad-spectrum antibiotics in view of the possibility of a serious bacterial infection, but there was no clinical effect. CT of the pelvis revealed an osteolytic process and a mass anterior to the pubic symphysis. Histological investigation of a biopsy revealed an inflammatory infiltrate with signs of gout. Culture of the biopsy specimen was negative. The diagnosis was confirmed by the finding ofneedle-like urate crystals under the polarizing microscope. After treatment with colchicine and later with prednisone, the symptoms disappeared. She was given uric acid-lowering therapy with allopurinol as a preventive measure.
authors.affiliation: Martini Ziekenhuis, afd. Interne Geneeskunde, Postbus 30.033, 9700 RM Groningen.
authors.forename: M
authors.initials: M
authors.lastname: van den Berge
authors.forename: B
authors.initials: B
authors.lastname: Vrugt
authors.forename: C
authors.initials: C
authors.lastname: Holt
authors.forename: C J
authors.initials: CJ
authors.lastname: Smit
authors.forename: K
authors.initials: K
authors.lastname: Hoogenberg
mesh_terms: D000369:Aged, 80 and over; D000493:Allopurinol / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D003460:Crystallization; D004359:Drug Therapy, Combination; D005260:Female; D006073:Gout / Q000150:complications* / Q000188:drug therapy; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D017699:Pelvic Pain / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome; D014527:Uric Acid / Q000378:metabolism
chemical_list: D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol; D003078:Colchicine; D011241:Prednisone