Nasal gouty tophus: case report
DOI:
https://doi.org/10.54495/Rev.Cientifica.v31i1.288Keywords:
Gout, gouty tophus, nasal dorsum, unusual locationAbstract
Gout is a purine metabolism disorder characterized by accumulation of uric acid due to increased production or decreased excretion. Over time, excess monosodium urate allows it to be accumulated in different body tissues, although the occurrence in the facial area is particularly infrequent. A 56- year-old male patient with a gout antecedent from 38 years ago that presented gouty tophi at the level of the upper and lower limbs seek medical advice due to an indurated slightly painful lesion at the level of the middle third of the nasal dorsum that started 4 years before and has been increasing in size. The lesion was causing nasal pyramid deformity and a slight sensation of bilateral nasal obstruction, for which surgical resolution is planned. The histopathological analysis of the samples sent under surgical exeresis confirms that the tissue sample corresponds to gouty tophi. Gouty tophi can appear in different tissues, such as cartilage, membranes and synovial fluid, joint surfaces, being exceptionally rare in the myocardium, mitral and aortic valves, eyes, nose and spinal cord. The place of presentation can be very variable, as well as its size.
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Bergamaschi, J. A., da Costa Huve, F., von Holleben, I., Bauer, J. A., Deutsch, K. M., & Piltcher, O. (2014). Nasal gouty tophus presenting as nasal obstruction: a case report. International Archives of Otorhinolaryngology, 18(S 01), a2260. http://doi.org/10.1055/s-0034-1388920 DOI: https://doi.org/10.1055/s-0034-1388920
Chhana, A., & Dalbeth, N. (2015). The gouty tophus: a review. Current Rheumatology Reports, 17(3), 1-9. https://doi.org/10.1007/s11926-014-0492-x DOI: https://doi.org/10.1007/s11926-014-0492-x
Feijóo Lamagrande, L., Gómez Bravo, F., Mayo Martín, F., García Cabeza, J. M., Fernández Sánchez, V., García Olbés, A., & García Martínez, A. (2000). Localización inusual de tofo gotoso: pirámide nasal. Cirugía Española, 67(5), 503-505.
Fields, T. R. (2019). The challenges of approaching and managing gout. Rheumatic Disease Clinics, 45(1), 145-157. https://doi.org/10.1016/j.rdc.2018.09.009 DOI: https://doi.org/10.1016/j.rdc.2018.09.009
Franco, G. N., Palencia, A. B., Inzunza, B. B., Champet, A. M., & Siu, C. M. (2009). Tofos gotosos. Revista del Centro Dermatológico Pascua, 18(3), 92-95.
Gaviria, J. L., Ortega, V. G., Gaona, J., Motta, A., & Medina Barragán, O. J. (2015). Unusual Dermatological Manifestations of Gout: Review of Literature and a Case Report. Plastic and reconstructive surgery. Global Open, 3(7), e445. https://doi.org/10.1097/GOX.0000000000000420 DOI: https://doi.org/10.1097/GOX.0000000000000420
Grassi, W., & De Angelis, R. (2011). Clinical features of gout. Reumatismo, 63(4), 238-245. ttps://doi.org/10.4081/reumatismo.2011.238 DOI: https://doi.org/10.4081/reumatismo.2011.238
Hughes, J. P., Di Palma, S., & Rowe-Jones, J. (2005). Tophaceous gout presenting as a dorsal nasal lump. The Journal of Laryngology & Otology, 119(6), 492-494. htpp://doi.org/10.1258/0022215054273160 DOI: https://doi.org/10.1258/0022215054273160
IIliev, G., Ivanova, P. P., Nedev, P., & Popov, H. (2019). Rare manifestation of gout: gouty tophi in the nose. Annals of Plastic Surgery, 82(6), 642-645. https://doi.org/10.1097/SAP.0000000000001778 DOI: https://doi.org/10.1097/SAP.0000000000001778
Ioannou P., & Panagiotakis S. (2018). Chronic tophaceous gout. Pan African Medical Journal, 30 (1). https://doi.org/10.11604/pamj.2018.30.64.15292 DOI: https://doi.org/10.11604/pamj.2018.30.64.15292
Kwak, P. E., Gorman, B. K., & Olson, K. L. (2013). Nasal gout presenting as nasal obstruction. JAMA Otolaryngology–Head & Neck Surgery, 139(4), 411-413. https://doi.org/10.1001/jamaoto.2013.220 DOI: https://doi.org/10.1001/jamaoto.2013.220
Ning, T. C., & Keenan, R. T. (2010). Unusual clinical presentations of gout. Current Opinion in Rheumatology, 22(2), 181-187. https://doi.org/ 10.1097/BOR.0b013e3283361ac0 DOI: https://doi.org/10.1097/BOR.0b013e3283361ac0
Parodi, P. C., De Biasio, F., Nadalig, B., & Ricci, S. (2006). Tophaceous lesion of the middle third of the nose. Dermatologic surgery, 32(4), 556-557. DOI: https://doi.org/10.1097/00042728-200604000-00013
Scriver, C. R., Sly, W. S., Childs, B., Beaudet, A. L., Valle, D., Kinzler, K. W., & Vogelstein, B. (2001). The Metabolic and Molecular Bases of Inherited Disease. McGraw-Hill.
Tausche, A. K., & Aringer, M. (2016). Gicht. Zeitschriftfür Rheumatologie, 75(9), 885-898. https://doi.org/10.1007/s00393-016-0206-z DOI: https://doi.org/10.1007/s00393-016-0206-z
Terkeltaub, R. (2017). What makes gouty inflammation so variable?. BMC. Medicine, 15(1), 1-10. https://link.gale.com/apps/doc/A511285837/AONE?u=googlescholar&sid=googleScholar&xid=5f1990c3 DOI: https://doi.org/10.1186/s12916-017-0922-5
Wilson, L., & Saseen, J. J. (2016). Gouty arthritis: a review of acute management and prevention. Pharmacotherapy. The Journal of Human Pharmacology and Drug Therapy, 36(8), 906-922. https://doi.org/10.1002/phar.1788 DOI: https://doi.org/10.1002/phar.1788
Wu, J. C., Chou, P. Y., & Chen, C. H. (2016). Nasal gouty tophus: report a rare case presenting as a nasal hump with nasal obstruction. Biomedical Journal, 39(4), 295-297. https://doi.org/10.1016/j.bj.2016.05.002 DOI: https://doi.org/10.1016/j.bj.2016.05.002
Yang, Q. B., He, Y. L., Zhong, X. W., Xie, W. G., & Zhou, J. G. (2019). Resveratrol ameliorates gouty inflammation via upregulation of sirtuin 1 to promote autophagy in gout patients. Inflammopharmacology, 27(1), 47-56. https://doi.org/10.1007/s10787-018-00555-4 DOI: https://doi.org/10.1007/s10787-018-00555-4
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