title: An unusual patient with hypothyroidism, tophaceous gout, and marked joint destruction.
abstract: This report describes a 75-year-old Caucasian man with extensive urate deposits and severe gouty arthropathy that confined him to a wheelchair. Since age 50, he suffered multiple acute gout flares and progressive deformities in his hands, feet, knees, and elbows (tophi). Serum creatinine was 1.4 mg/dL and serum urate 9.4 mg/dL. Conditions known to increase uric acid production (psoriasis, chronic bronchitis) and to decrease uric acid excretion (hypothyroidism, metabolic syndrome, and nephroangiosclerosis) may operate in a single patient, illustrating the dramatic clinical course of untreated gout.
authors.affiliation: Divisions of Internal Medicine, La Paz University Hospital, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Montoya
authors.forename: R J
authors.initials: RJ
authors.lastname: Torres
authors.forename: J M
authors.initials: JM
authors.lastname: Fraile
authors.forename: J G
authors.initials: JG
authors.lastname: Puig
mesh_terms: D000368:Aged; D006073:Gout / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007037:Hypothyroidism / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology*; D007596:Joints / Q000473:pathology*; D008297:Male; D014527:Uric Acid / Q000378:metabolism
chemical_list: D014527:Uric Acid