Indan Journal of Medical Research Indan Journal of Medical Research Indan Journal of Medical Research
  Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login  
  Home Print this page Email this page Small font sizeDefault font sizeIncrease font size Users Online: 4152       

   Table of Contents      
CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 29

Tuberous xanthomas mimicking tophaceous gout


1 Department of Internal Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar 751 024, Odisha, India
2 Department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751 024, Odisha, India

Date of Submission20-Aug-2019
Date of Web Publication25-May-2021

Correspondence Address:
Prasanta Padhan
Department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751 024, Odisha
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1426_19

Rights and Permissions

How to cite this article:
Dhanawat A, Padhan P. Tuberous xanthomas mimicking tophaceous gout. Indian J Med Res 2020;152, Suppl S1:29

How to cite this URL:
Dhanawat A, Padhan P. Tuberous xanthomas mimicking tophaceous gout. Indian J Med Res [serial online] 2020 [cited 2021 Aug 4];152, Suppl S1:29. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/29/316716

A 43 yr old non-diabetic and non-hypertensive male presented to the department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, India, in January 2019, with multiple nodules in both hands and bilateral heel pain for five years. No similar history in the family was observed. Examination revealed firm, non-tender nodules on the dorsum of both hands [Figure 1] and tenderness with minimal swelling of bilateral Achilles tendon. Systemic examination was normal. His complete blood counts, kidney function tests, liver function tests, erythrocyte sedimentation rate, C-reactive protein, and serum uric acid were normal. He had elevated serum total cholesterol (900 mg/dl), low-density lipoprotein (571 mg/dl), triglycerides (217 mg/dl), high-density lipoprotein (126 mg/dl) with very low-density lipoprotein being normal. Evaluation for coronary artery disease was negative. Eye examination revealed corneal arcus [Figure 2]. A diagnosis of tuberous xanthoma was made. Tophaceous gout is a common differential for this condition where monosodium urate crystals are deposited over ligaments and tendons with repeated painful attacks in the background of hyperuricemia. He received atorvastatin and ezetimibe along with analgesics and physiotherapy. Follow up after three months revealed reductions in lipid levels and improvement of heel pain.
Figure 1: Multiple, firm, non-tender nodules of various sizes on the dorsum of both hands.

Click here to view
Figure 2: Corneal arcus (white arrows) along with cholesterol xanthomas (black arrows) in both eyes.

Click here to view


Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2]



 

Top
 
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Article Figures

 Article Access Statistics
    Viewed206    
    Printed0    
    Emailed0    
    PDF Downloaded35    
    Comments [Add]    

Recommend this journal