General Surgery Unit, Department of Surgery, Bowen University Teaching Hospital, Iwo, Osun State, Nigeria.
Anatomic Pathology, Department of Pathology, Bowen University Teaching Hospital, Iwo, Osun State, Nigeria.
Ghana Med J. 2024 Sep;58(3):245-248. doi: 10.4314/gmj.v58i3.10.
Gouty tophus in a child is an extremely rare presentation. Only very few cases have been documented in literature in contemporary times.
We present this index case of a 6-year-old child who was brought to the clinic by her parents on account of multiple subcutaneous swelling of two years' duration on her lower limbs before she presented at our outpatient clinic. The swellings started from the knee joints and were associated with difficulty in walking. A provisional diagnosis of multiple soft tissue swelling was made before some of the swellings were excised. An excisional biopsy of some of the masses on the lower extremities was done, and histological examination revealed gouty tophus. She was then placed on oral febuxostat. Her clinical condition has improved significantly; she is on continuous follow-up at our facility's paediatric orthopaedic outpatient clinic. Hitherto, gouty tophus has been recorded in juveniles and young adults, but it may present in any child below the age of five years.
A high index of suspicion is needed in managing subcutaneous swellings in the paediatric age group (particularly pre-school) to identify and manage gouty tophus early enough to minimise its complications.
None declared.
儿童痛风石极为罕见。在现代文献中，仅有极少数病例被记录。
我们报告了这例 6 岁儿童的病例，其父母带她到诊所就诊，原因是她的下肢有多个皮下肿块，病程已有两年，在她到我们的门诊就诊之前，这些肿块已出现在膝关节，并伴有行走困难。在对一些肿块进行切除之前，我们初步诊断为多发性软组织肿块。对下肢的一些肿块进行了切除活检，组织学检查显示为痛风石。随后，她开始口服非布司他。她的临床状况明显改善，目前正在我们的小儿矫形门诊进行持续随访。到目前为止，痛风石已在青少年和年轻成年人中记录，但它也可能发生在任何 5 岁以下的儿童。
在管理儿科年龄组（特别是学龄前儿童）的皮下肿块时，需要高度怀疑痛风石的可能性，以便及早发现和治疗痛风石，以最大程度地减少其并发症。
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