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Miliarial-type gout in association with chronic use of glucocorticoids

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Abstract

A 59-year-old male patient with long-standing tophaceous gout (more than 30 years) characterized by polyarticular involvement and recurrent disseminated tophi formation; his past medical history is relevant for poor adherence to urate-lowering medications, as well as persistent use of self-prescribed systemic glucocorticoids. Despite achieving therapeutic goals for serum uric acid levels, new tophi formation with an intradermal location in the form of “miliarial-type gout” was documented. Due to functional limitations, the patient underwent surgical resection of the olecranon bursa. This case illustrates a widespread and recurrent tophi formation associated with long-standing gout and regular and sustained glucocorticoid use, despite an adequate disease control based on serum urate levels and involving an intradermal location of tophi presenting as “miliarial-type” lesions. In addition, the coexistence of urate and cholesterol crystal deposition disease in olecranon gouty bursitis is presented. Finally, a sonographic extended field of view of lesions distributed along the patient’s extremities is presented as a novel characterization of this condition.

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The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Rheumatology Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico

    A. Enríquez-Luna, C. Soto-Fajardo, F. Carranza-Enríquez, D. Clavijo-Cornejo & C. Pineda

  2. Gerosciences Laboratory, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico

    A. Lopez-Reyes

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  1. A. Enríquez-Luna
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  2. C. Soto-Fajardo
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  3. F. Carranza-Enríquez
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  4. D. Clavijo-Cornejo
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  5. A. Lopez-Reyes
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  6. C. Pineda
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Correspondence to C. Pineda.

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Enríquez-Luna, A., Soto-Fajardo, C., Carranza-Enríquez, F. et al. Miliarial-type gout in association with chronic use of glucocorticoids. Rheumatol Int 44, 543–547 (2024). https://doi.org/10.1007/s00296-023-05486-0

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  • DOI: https://doi.org/10.1007/s00296-023-05486-0

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