Pediatric Nephrology

, Volume 25, Issue 12, pp 2535–2538 | Cite as

Gout in pediatric renal transplant recipients

  • Johannes Trück
  • Guido F. Laube
  • Rodo O. von Vigier
  • Philippe GoetschelEmail author
Brief Report


Clinical gout has rarely been described after pediatric renal transplantation (RTx), although asymptomatic hyperuricemia is common in these patients. We describe three male pediatric patients who presented with gouty arthritis 7–8.5 years following RTx. Since receiving allopurinol, all patients had been free of gouty symptoms. To prevent severe bone marrow depletion, the dosage of azathioprine, an immunosupressant drug, was reduced by 50% to prevent interaction with allopurinol. Because atypical presentation of gout can occur, a high index of suspicion is needed to allow appropriate diagnosis of this disease in patients with skeletal pain after RTx.


Kidney transplantation Gout Hyperuricemia Children Azathioprine Allopurinol 



We thank Dr. Philip Went for providing photos of Fig. 2 and Dr. Jan Janzen for helping with the interpretation of the histopathology.

Conflicts of interest

The authors declare that they have no conflicts of interest in writing the article.


  1. 1.
    Abbott KC, Kimmel PL, Dharnidharka V, Oglesby RJ, Agodoa LY, Caillard S (2005) New-onset gout after kidney transplantation: incidence, risk factors and implications. Transplantation 80:1383–1391CrossRefPubMedGoogle Scholar
  2. 2.
    Clive DM (2000) Renal transplant-associated hyperuricemia and gout. J Am Soc Nephrol 11:974–979PubMedGoogle Scholar
  3. 3.
    Richette P, Bardin T (2010) Gout. Lancet 375:318–328CrossRefPubMedGoogle Scholar
  4. 4.
    Sparta G, Kemper MJ, Neuhaus TJ (2006) Hyperuricemia and gout following pediatric renal transplantation. Pediatr Nephrol 21:1884–1888CrossRefPubMedGoogle Scholar
  5. 5.
    Pela I, Seracini D, Lavoratti G, Materassi M (1999) Acute gouty arthritis in adolescents with renal transplants. Pediatr Med Chir 21:135–137PubMedGoogle Scholar
  6. 6.
    Cohen MR (1994) Proximal gout following renal transplantation. Arthritis Rheum 37:1709CrossRefPubMedGoogle Scholar
  7. 7.
    Yu KH, Luo SF, Liou LB, Wu YJ, Tsai WP, Chen JY, Ho HH (2003) Concomitant septic and gouty arthritis–an analysis of 30 cases. Rheumatology (Oxford) 42:1062–1066CrossRefGoogle Scholar
  8. 8.
    Fisher MC, Goldsmith JF, Gilligan PH (1985) Sneakers as a source of Pseudomonas aeruginosa in children with osteomyelitis following puncture wounds. J Pediatr 106:607–609CrossRefPubMedGoogle Scholar
  9. 9.
    McCarty DJ (1994) Gout without hyperuricemia. JAMA 271:302–303CrossRefPubMedGoogle Scholar
  10. 10.
    Perez-Ruiz F, Gomez-Ullate P, Amenabar JJ, Zarraga S, Calabozo M, Herrero-Beites AM, Nolla JM (2003) Long-term efficacy of hyperuricaemia treatment in renal transplant patients. Nephrol Dial Transplant 18:603–606CrossRefPubMedGoogle Scholar
  11. 11.
    Stamp L, Searle M, O'Donnell J, Chapman P (2005) Gout in solid organ transplantation: a challenging clinical problem. Drugs 65:2593–2611CrossRefPubMedGoogle Scholar

Copyright information

© IPNA 2010

Authors and Affiliations

  • Johannes Trück
    • 1
  • Guido F. Laube
    • 2
  • Rodo O. von Vigier
    • 3
  • Philippe Goetschel
    • 1
    Email author
  1. 1.Department of PediatricsTriemli Hospital ZurichZurichSwitzerland
  2. 2.Nephrology UnitUniversity Children’s Hospital ZurichZurichSwitzerland
  3. 3.Pediatric NephrologyUniversity Children’s Hospital Bern InselspitalBernSwitzerland

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