Colchicine-responsive protracted gouty arthritis with systemic inflammatory reactions

Abstract Acute gouty arthritis is a severe but self-limiting arthritis caused by inflammatory responses to urate crystals. Oral colchicines are effective for initial stages or prophylaxis, but generally, colchicines are ineffective for established gouty arthritis. We describe an unusual case of gout...

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Bibliographic Details
Published in:Modern rheumatology 2014-05, Vol.24 (3), p.540-543
Main Authors: Nonaka, Fumiaki, Migita, Kiyoshi, Haramura, Tomoko, Sumiyoshi, Remi, Kawakami, Atsushi, Eguchi, Katsumi
Format: Article
Language:English
Subjects:
Arthritis
Arthritis, Gouty - complications
Arthritis, Gouty - drug therapy
Arthritis, Gouty - genetics
Colchicine - therapeutic use
Cytoskeletal Proteins - genetics
Fever - complications
Fever - drug therapy
Fever - genetics
Genetics
Gout Suppressants - therapeutic use
Humans
Inflammatory diseases
Male
Middle Aged
Mutation
Pyrin
Rheumatism
Rheumatology
Treatment Outcome
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Summary:Abstract Acute gouty arthritis is a severe but self-limiting arthritis caused by inflammatory responses to urate crystals. Oral colchicines are effective for initial stages or prophylaxis, but generally, colchicines are ineffective for established gouty arthritis. We describe an unusual case of gouty arthritis with systemic inflammatory reactions, including high fever and polymyalgia. Refractory polyarthritis and high fever were eradicated by colchicine treatment. Genetic analysis revealed a heterozygous mutation in exon 2 of the MEFV gene (E148Q). This case underscores the possibility that MEFV gene mutations may modify the phenotype of gouty arthritis.
ISSN:1439-7595
1439-7609
DOI:10.3109/14397595.2013.874732