Coexistent gout and systemic lupus erythematosus

Abstract

We are unaware of any previous report concerning the coexistence of gout and systemic lupus erythematosus (SLE). Since gout is a relatively common disease affecting over 500,000 Americans (l), it seems likely that it would occur in some patients with SLE. In fact, on the basis of disease prevalence data (2), approximately 100 cases of coexistent gout and SLE might be expected in the United States (Table 1). This report documents the first known case of coexistent gout and SLE, and the various factors that may contribute to the lack of association between these diseases are discussed. Case Report. The patient was a 48-year-old white man who was first seen at the Ann Arbor Veterans Administration Medical Center in November 1979 with nephrotic syndrome. He had a 10-year history of intermittent arthralgia of the ankles, feet, hands, and elbows, a 15-year history of intermittent urticaria, a positive LE cell test, and hypocomplementemia. The patient had been treated with 5-10 mg prednisone per day for 5 years. In 1978 he developed hypertension, 10-pound weight gain, and proteinuria. The serum uric acid was 13 mg/100 ml. He was placed on diuretics and continued on low dose prednisone, but by 1979 severe peripheral edema and fatigue developed. The patient denied a history of Raynaud's phenomenon, mucosal ulcerations, alopecia, and photosensitivity. The physical examination was remarkable for a blood pressure of 215/105 and 4+ pitting edema up to the knees. Laboratory data included hemoglobin 1 1.3 gm/ 100 ml, hematocrit 3 1.7%, white blood count 5,300, platelets 220,000, BUN 25 mg/100 ml, creatinine 1.9 mg/100 ml, uric acid 11 mg/100 ml, creatinine clear-