Azzam Ali, Balasubramaniam Renuka, Safa Shahram, McIvor Carolyn, Mollee Peter
Department of Gastroenterology, Logan Hospital, Queensland, Australia.
Amyloidosis Centre, Princess Alexandra Hospital, Queensland, Australia; School of Medicine, University of Queensland, Queensland, Australia.
ACG Case Rep J. 2017 Mar 1;4:e32. doi: 10.14309/crj.2017.32. eCollection 2017.
Many chronic inflammatory conditions can lead to systemic amyloidosis. However, secondary amyloidosis has rarely been associated with gout, and the literature reports only a handful of cases, all presenting with renal disease. We report a patient with a history of poorly controlled gout who presented with malabsorption. Endoscopic biopsies confirmed a diagnosis of small intestinal amyloidosis. This was believed to be a consequence of gout. Interestingly, renal involvement was subclinical. Our case raises awareness of this rare association and highlights the importance of considering a diagnosis of amyloidosis in patients who present with the combination of gout and gastrointestinal symptoms.
许多慢性炎症性疾病可导致系统性淀粉样变性。然而,继发性淀粉样变性很少与痛风相关,文献仅报道了少数病例,均表现为肾脏疾病。我们报告一例痛风控制不佳的患者,该患者出现吸收不良。内镜活检确诊为小肠淀粉样变性。这被认为是痛风的结果。有趣的是,肾脏受累为亚临床状态。我们的病例提高了对这种罕见关联的认识,并强调了在出现痛风和胃肠道症状的患者中考虑淀粉样变性诊断的重要性。