Abstract
Gouty arthritis is uncommon in childhood and adolescence. On the other hand, there has been no report of cases with development of gouty arthritis with post-streptococcal acute glomerulonephritis (PSAGN) in pediatric patients. Here we report the case of a mildly obese 12-year-old boy with PSAGN complicated by gouty arthritis of the left first metatarsophalangeal joint. On follow-up, it was confirmed that as serum C3 level returned to normal, urinary excretion of uric acid increased and serum uric acid level decreased, thereby resolving the burning pain of the left big toe. In this case, not only did renal insufficiency associate with PSAGN but also mild obesity may have led to hyperuricemia and gouty arthritis. In conclusion, clinicians should be aware that PSAGN may be complicated by gouty arthritis in obese pediatric patients.
Highlights
Gout is a common medical problem [1, 2] that usually develops after middle age
Hyperuricemia is known to be moderately to highly associated with renal dysfunction [4] and chronic glomerulonephritis in adults is often accompanied by hyperuricemia that results from decline in glomerular filtration rate (GFR) [5]
Juvenile gouty arthritis is a very rare disease [3]. The course of this patient provides an example of post-streptococcal acute glomerulonephritis (PSAGN) that was complicated by gouty arthritis in an obese pediatric patient
Summary
Gout is a common medical problem [1, 2] that usually develops after middle age. Juvenile gouty arthritis, on the other hand, is a less common disease [3]. There have been no reports of cases with development of gouty arthritis with post-streptococcal acute glomerulonephritis (PSAGN) in pediatric patients. We describe the case of a mildly obese 12-year-old boy with PSAGN that was complicated by gouty arthritis of the left first metatarsophalangeal joint (MTP1).
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