title: Refractory gout attack.
abstract: Refractory gout attack is an uncommon problem, since gout flares are usually self-limited. This clinical condition is characterized by serum uric acid higher than 6 mg/Dl or continuous manifestations of recurrent flares, chronic arthritis, and increased tophi. We report in this paper a 69-year-old man with a polyarticular and protracted gout attack, despite usual treatment and low urate sera levels. In order to manage this problem, we reviewed gout pathophysiology and developed a therapeutic solution based on benzbromarone pharmacokinetics. We also review herein new options for gout treatment that could be used in similar cases.
authors.affiliation: Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo (USP), Avenida Doutor Arnaldo 455, 01246-903 São Paulo, SP, Brazil.
authors.forename: Simone
authors.initials: S
authors.lastname: Fargetti
authors.forename: Claudia
authors.initials: C
authors.lastname: Goldenstein-Schainberg
authors.forename: Andressa
authors.initials: A
authors.lastname: Silva Abreu
authors.forename: Ricardo
authors.initials: R
authors.lastname: Fuller