A Rare Cause of Knee Pain in Gout Patients: Tophi of Patella

Aşkın, Ayhan; İnci, Rahime; Akan, O.; Demirdal, Seçil; Bayram, Korhan Barış

doi:10.5606/archrheumatol.2015.5357

Cited by 5 publications

(4 citation statements)

References 15 publications

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“…It was demonstrated that lead exposure positively correlated with uric acid levels in asymptomatic subjects with risk for occupational lead exposure. 10 Furthermore, previous studies have shown that hyperuricemia might ensue due to lead intoxication 2,11,12 eventually causing hypertension and kidney injury as well. [11][12][13][14][15] However, the pertinent literature mainly comprises studies whereby the mean lead exposure time was longer than 10 years.…”

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confidence: 99%

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The Effects of Lead Exposure on Serum Uric Acid and Hyperuricemia in Young Adult Workers: A Cross-sectional Controlled Study

et al. 2016

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Objectives: This study aims to evaluate the relationship between serum uric acid levels and renal functions in asymptomatic subjects who had occupational lead exposure, particularly for shorter durations whereby saturnine gout has also been discussed. Patients and methods:In this retrospective study, files of 100 males (mean age 34.5±5.9 years; range, 21 to 47 years) with occupational risk for lead exposure and 100 healthy male controls (mean age 34.47±5.8 years; range 21 to 47 years) were reviewed. Demographic characteristics of the subjects and laboratory test results were recorded from the files. Creatinine clearance and 24-hour urinary creatinine were measured in the lead-exposed group. Results: In the lead-exposed group, mean serum uric acid level was higher than those of the control group (p<0.001). Lead exposure time was negatively correlated with 24-hour urinary creatinine levels (r= -0.373, p<0.001). In addition, serum uric acid levels were positively correlated with serum creatinine levels (r=0.412, p<0.001) in the exposed group. Six patients had hyperuricemia (serum uric acid level >6.8 mg/dL) in the leadexposed group; however, all subjects' serum uric acid level was lower than 6.8 mg/dL in the control group (p=0.029). Although 22 subjects had higher uric acid levels than 6.0 mg/dL in the lead-exposed group, only one control had higher uric acid level than 6.0 mg/dL (p<0.001). Conclusion:In light of our results, we may conclude that workers with lead exposure have higher frequency of hyperuricemia and higher serum uric acid levels than those of the control group. Therefore, we may imply that higher serum uric acid levels may be associated with renal impairment in lead-exposed subjects even in the earlier stages of exposure.

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“…1,2 On the other hand, saturnine gout is the rheumatic entity due to chronic lead toxicity. 3 Previous studies have established that lead exposure causes renal dysfunction via direct tubular damage, tubulointerstitial fibrosis and increased reactive oxygen radicals.…”

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The Effects of Lead Exposure on Serum Uric Acid and Hyperuricemia in Young Adult Workers: A Cross-sectional Controlled Study

et al. 2016

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“…Bone erosions typically occur at the sites of tophi formation [4]. Gout involvement of the extensor tendons of the knee is not uncommon, but involvement of the patella is rare [5], [6].…”

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Tophaceous gout with rare involvement of the patella

Clark

Evans

Armstrong

et al. 2016

Radiology Case Reports

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Gout arthritis is an inflammatory arthritis caused by hyperuricemia from various etiologies. It is typically a polyarticular arthritis with the most common joint involved being the first metatarsophalangeal joint. We present a case of gout of the knee with characteristic magnetic resonance imaging findings and rare involvement of the patella. Radiographic findings of gout are diagnostic; however, they manifest many years after the onset of the disease process. Control of symptoms and progression of the disease is possible with correct treatment made possible by early diagnosis.

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“…Osteoarthritis (OA) was excluded as well because the American College of Rheumatology criteria for hand OA diagnosis were not respected. 4 Besides, causes of metabolic OA associated with metabolic syndrome such as overweight, 5 dyslipidemia, 6 hyperglycemia, 7 and vitamin D deficiency 8 were excluded since the patient did not present these key components of metabolic OA. A written informed consent was obtained from the patient.…”

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confidence: 99%