高尿酸血症の持続により持続性の多発関節炎を呈した慢性結節性痛風の一例 A case of chronic tophaceous with a continuous polyarthritis and joint deformity caused by uncontrolled hyperuricemia

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著者

    • 川尻 真也 KAWASHIRI Shinya
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 川上 純 KAWAKAMI Atsushi
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 岩本 直樹 IWAMOTO Naoki
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 藤川 敬太 FUJIKAWA Keita
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 荒牧 俊幸 ARAMAKI Toshiyuki
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 一瀬 邦弘 ICHINOSE Kunihiro
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 蒲池 誠 KAMACHI Makoto
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 玉井 慎美 TAMAI Mami
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 中村 英樹 NAKAMURA Hideki
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 井田 弘明 IDA Hiroaki
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 折口 智樹 ORIGUCHI Tomoki
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University
    • 江口 勝美 EGUCHI Katsumi
    • 長崎大学大学院医歯薬学総合研究科病態解析・制御学講座(第一内科) Unit of Translational Medicine, Department of Immunology and Rheumatology, Graduate School of Biomedical Sciences, Nagasaki University

抄録

  症例は56歳,女性.主訴は多発関節痛.1999年に拇趾MTP関節の痛風発作を発症した.その後,痛風発作を繰り返すもコルヒチン内服にて症状は軽快していた.しかし,2006年頃より関節痛は全身の多関節におよび,持続性となった.2007年4月,多発関節炎の精査加療目的にて当科紹介入院となった.入院時,著明な高尿酸血症を認めた.入院中,関節炎発作による全身の関節痛および高熱を認めた.関節液所見にて白血球に貪食された尿酸ナトリウム針状結晶を認め,痛風と診断した.デキサメタゾン4 mg筋注およびコルヒチン投与により症状は改善した.<br>

  A 56-year-old woman was admitted to our hospital in April 2007 due to a history of polyarthralgia. In 1999, She had been diagnosed as having gout by monoarthritis of the first metatarsophalangeal joint. She was treated with only cholchine. Subsequently she repeatedly got acute attack once a year. In 2006, episodic monoarthritis became to be continuous polyarthritis. Laboratory examination at admission showed remarkable hyperuricemia. At 3 day after hospitalization, she experienced acute attack and high fever. Diagnosis of chronic gout was confirmed by the identification of monosodium urate crystals in the synovial fluid. Her symptom improved by a treatment with dexamethasone 4 mg/day i.m. and cholchine, and did not experience acute attack for 5 months. We suggest that prophylactic administration of cholchine is beneficial in refractory chronic gout patient.<br>

収録刊行物

  • 日本臨床免疫学会会誌 = Japanese journal of clinical immunology  

    日本臨床免疫学会会誌 = Japanese journal of clinical immunology 31(3), 190-194, 2008-06-30 

    日本臨床免疫学会

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各種コード

  • NII論文ID(NAID)
    10021242809
  • NII書誌ID(NCID)
    AN00357971
  • 本文言語コード
    JPN
  • 資料種別
    NOT
  • ISSN
    09114300
  • データ提供元
    CJP書誌  IR  J-STAGE 
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