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[一名无全身性痛风或正常尿酸血症患者的腰椎痛风石性痛风]

[Tophaceous gout of the lumbar spine in a patient without systemic gout or normouricaemia].

作者信息

Lorente Alejandro, Lorente Rafael, Romero Jorge

机构信息

Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.

Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Infanta Cristina, Badajoz, España.

出版信息

Neurocirugia (Astur). 2017 Sep-Oct;28(5):242-246. doi: 10.1016/j.neucir.2017.02.001. Epub 2017 Apr 21.

Abstract

Gout is a common metabolic disorder typically diagnosed in peripheral joints. Tophaceous deposits in the lumbar spine is a very rare condition with very few cases reported in the literature. We present a case of tophaceous gout that originated in the lumbar spine in a patient with normal uric acid blood levels. The following case report concerns a 52-year-old patient with low back pain, left sciatica and numbness in the left leg. Serum uric acid levels were within normal range. MRI and bone scan images suggested an inflammatory-infectious process focussed at L4. After an L4-L5 decompressive laminectomy, histological examination revealed tissue infiltrated with mature plasma cells with negatively birefringent crystals using polarised light consistent with urate deposits.

摘要

痛风是一种常见的代谢紊乱疾病,通常在外周关节被诊断出来。腰椎出现痛风石沉积是一种非常罕见的情况,文献中报道的病例极少。我们报告一例血尿酸水平正常的患者,痛风石起源于腰椎。以下病例报告涉及一名52岁患者,其有腰痛、左侧坐骨神经痛和左腿麻木症状。血清尿酸水平在正常范围内。MRI和骨扫描图像显示炎症感染过程集中在L4。在进行L4 - L5减压椎板切除术后,组织学检查显示组织中有成熟浆细胞浸润,使用偏振光观察到与尿酸盐沉积一致的负性双折射晶体。

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