MR Vol.14 No.5 indexに戻る

MODERN　RHEUMATOLOGY Vol.14　No.5 　 　　　　　　　　　　
A case of female premenopausal tophaceous gout requiring surgical management
Fujio Nakazawa1, Hirokazu Ishihara2 and Koudai Tanaka3

(1) Fujikoshi-Hospital Orthopedic Surgery, 11-65 Ishigane, Toyama 930-0964, Japan
(2) Department of Orthopedic Surgery, Toyama Medical and Pharmaceutical University, Toyama, Japan
(3) Department of Psychology, Toyama Medical and Pharmaceutical University, Toyama, Japan

Received: 13 August 2003 Accepted: 24 June 2004
Abstract
We report a case of tophaceous gout in a 32-year-old woman who had suffered from anorexia nervosa since the age of 15. She had been taking a diuretic, mainly furosemide, to lose weight since she was 18. She was referred for orthopedic surgery because of a tophus at her right metatarsophalangeal joint. Because of a discharging sinus associated with the tophaceous deposits, surgery was performed. Use of the diuretic was stopped after surgery and the serum uric acid concentration returned to normal. It was thought that long-term abuse of a diuretic induced the tophaceous gout in this premenopusal woman.
 
Key words
Anorexia nervosa - Diuretic - Gout - Premenopause - Surgery
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