Gastrointestinal amyloidosis secondary to chronic tophaceous gout |
Sei-Hyun Kim, Kyu-Hyun Yoon, Woo-Jin Han, Jae-Jun Han, Hyo-Jin Choi, Han-Joo Baek |
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만성 통풍결절 환자에서 발생한 위장관 아밀로이드증 1예 |
김세현, 윤규현, 한우진, 한재준, 최효진, 백한주 |
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Abstract |
Secondary amyloidosis is associated with infectious, inflammatory, or neoplastic disorders. Gouty arthritis, unlike other forms of
chronic inflammatory arthritis, is not usually associated with amyloidosis. A 70‐year‐old man was admitted because of generalized
edema, anorexia, and diarrhea. He had been diagnosed with gouty arthritis 12 years earlier and took over-the-counter medication
during acute attacks. The physical examination revealed multiple tophi on his ears, right hand, and right foot. No evidence of amyloidosis
involving the heart or bone marrow was detected. Biopsy of the antrum, duodenum, ileum, and descending colon showed
green birefringence with Congo red stain. Immunohistochemistry was strongly positive for amyloid A. We diagnosed him as having
secondary gastrointestinal amyloidosis AA with chronic tophaceous gouty arthritis. Allopurinol was administered and oral prednisolone
was increased. However, he died from septic shock 25 days after admission. (Korean J Med 77:531-535, 2009) |
Key Words:
Gout; Amyloidosis |
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