Department of Internal Medicine, Chonbuk National University Medical School and Research Institute of Clinical Medicine, Deokjin-gu, Jeonju, South Korea.
Ren Fail. 2009;31(9):855-7. doi: 10.3109/08860220903151393.
We report a case of patient suffering from chronic tophaceous gout of multiple, large joints. The patient was diagnosed with acute renal failure by immobilization hypercalcemia and successfully treated with fluid and diuretics, rehabilitative exercises, and bisphosphonate, without further recurrence during six months follow-up. Acute renal failure can occur in the patient with gout as an acute uric acid nephropathy due to the deposition of uric acid within the renal tubules. Immobilization hypercalcemia is a rare cause of acute renal failure in patients with immobilization due to the limitation of motion. We suggest that immobilization can be a possible cause of hypercalcemia-induced acute renal failure in patients with chronic tophaceous gout involving multiple large joints, and clinical alertness is needed to avoid unnecessary evaluations and life-threatening complications.
我们报告了一例患有多处大关节慢性痛风石的患者。该患者因固定性高钙血症导致急性肾衰竭，经补液、利尿剂、康复运动和双膦酸盐治疗后成功治愈，在六个月的随访中未再复发。痛风患者可因尿酸在肾小管内沉积而发生急性尿酸肾病，导致急性肾衰竭。固定性高钙血症是因活动受限导致固定患者发生急性肾衰竭的罕见原因。我们建议，对于涉及多处大关节的慢性痛风石患者，固定性可能是高钙血症引起急性肾衰竭的一个潜在原因，临床医生应保持警惕，避免不必要的评估和危及生命的并发症。
