Seifried Rebecca M, Roberts Jefferson
Tripler Army Medical Center, Honolulu, HI 96859, USA.
Hawaii J Med Public Health. 2013 Jul;72(7):220-3.
This is a case report of a patient with treatment resistant gout who was prescribed pegloticase and developed a severe reaction. A 30-year-old Hawaiian-Filipino man presented with a nine-year history of gout that progressed from episodic monoarticular arthritis, treated with aspiration and corticosteroid injections, to more aggressive disease with more frequent attacks requiring escalation of therapy. He was treated with systemic corticosteroids, colchicine and nonsteroidal anti-inflammatory drugs, but then required allopurinol. Despite aggressive therapy, the patient continued to have hyperuricemia and tophi developed even after treatment with febuxostat and probenicid. The patient became wheel chair bound due to his pain and, at that point, the decision was made to initiate treatment with pegloticase. The patient initially experienced significant improvement with treatment; however, he soon began to have elevation in his serum uric acid levels and developed a severe reaction during treatment.
这是一例关于一名难治性痛风患者的病例报告，该患者被处方聚乙二醇化尿酸酶并出现了严重反应。一名30岁的夏威夷裔菲律宾男子，有9年痛风病史，最初为发作性单关节关节炎，通过关节穿刺抽液和皮质类固醇注射治疗，后来病情进展为更具侵袭性的疾病，发作更频繁，需要加强治疗。他接受了全身性皮质类固醇、秋水仙碱和非甾体抗炎药治疗，之后需要使用别嘌醇。尽管进行了积极治疗，但患者仍有高尿酸血症，即使在使用非布司他和丙磺舒治疗后仍出现了痛风石。由于疼痛，患者只能依靠轮椅行动，此时决定开始使用聚乙二醇化尿酸酶进行治疗。患者最初治疗后有明显改善；然而，他很快开始出现血清尿酸水平升高，并在治疗期间出现了严重反应。
