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    Symptomatic hypercalcemia in a patient with chronic tophaceous gout: a case report.

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    Authors
    Sachdeva, Alok
    Goeckeritz, Bruce E
    Oliver, Alyce M
    Issue Date
    2008-08-21
    URI
    http://hdl.handle.net/10675.2/140
    
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    Abstract
    ABSTRACT: Hypercalcemia has been widely associated with granulomatous processes. This is due to enhanced extra-renal conversion of calcidiol to calcitriol by activated macrophages within the granuloma. Symptomatic hypercalcemia due to granulomatous disorders is not common, with the incidence in sarcoidosis ranging from 10-20%. Large aggregates of monosodium urate crystals in patients with longstanding chronic tophaceous gout can serve as the inciting antigen for the development of granuloma, but hypercalcemia has not been described in this context. We report a case of symptomatic hypercalcemia due to gouty tophi induced granulomatous inflammation. Long term treatment with immunosuppressants, in addition to bisphosphonates and uric acid lowering therapy, has led to stabilization of serum calcium levels and other lab parameters indicative of granulomatous burden.
    Citation
    Cases J. 2008 Aug 7; 1:72
    ae974a485f413a2113503eed53cd6c53
    10.1186/1757-1626-1-72
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    Department of Medicine Faculty: Research and Presentations

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