Kuniyoshi Yasutaka, Kamura Azusa, Yasuda Sumie, Tashiro Makoto
Department of Pediatrics, Tsugaruhoken Medical CO-OP Kensei Hospital, 2-2-1 Noda, Hirosaki, Aomori, 036-8511, Japan.
Pediatr Rheumatol Online J. 2015 Jun 17;13:24. doi: 10.1186/s12969-015-0019-7.
Gouty arthritis is uncommon in childhood and adolescence. On the other hand, there has been no report of cases with development of gouty arthritis with post-streptococcal acute glomerulonephritis (PSAGN) in pediatric patients. Here we report the case of a mildly obese 12-year-old boy with PSAGN complicated by gouty arthritis of the left first metatarsophalangeal joint. On follow-up, it was confirmed that as serum C3 level returned to normal, urinary excretion of uric acid increased and serum uric acid level decreased, thereby resolving the burning pain of the left big toe. In this case, not only did renal insufficiency associate with PSAGN but also mild obesity may have led to hyperuricemia and gouty arthritis. In conclusion, clinicians should be aware that PSAGN may be complicated by gouty arthritis in obese pediatric patients.
痛风性关节炎在儿童和青少年中并不常见。另一方面，尚无小儿患者在患链球菌感染后急性肾小球肾炎（PSAGN）时并发痛风性关节炎的病例报告。在此，我们报告一例12岁轻度肥胖男孩，患有PSAGN并并发左第一跖趾关节痛风性关节炎。随访时证实，随着血清C3水平恢复正常，尿酸尿排泄增加，血清尿酸水平降低，从而缓解了左大脚趾的灼痛。在该病例中，不仅肾功能不全与PSAGN相关，而且轻度肥胖可能导致了高尿酸血症和痛风性关节炎。总之，临床医生应意识到肥胖小儿患者的PSAGN可能并发痛风性关节炎。
