TITLE:
Rare Association between Chronic Tophaceous Gout and Rheumatoid Arthritis in a Black African Subject: A Case Report
AUTHORS:
Yannick Laurent Tchenadoyo Bayala, Abdoul Aziz, Ismael Ayouba Tinni, Fulgence Kaboré, Wenlassida Joëlle Stéphanie Zabsonré/Tiendrebeogo, Dieu-Donné Ouedraogo
KEYWORDS:
Arthritis, Gout, Rheumatoid Arthritis, Tophus, Africa
JOURNAL NAME:
Open Journal of Rheumatology and Autoimmune Diseases,
Vol.13 No.4,
November
2,
2023
ABSTRACT: Rheumatoid
arthritis (RA) and gout are common diseases, but their coexistence is rare. We
describe the case of a 76-year-old man with hypertension who had been treated
for gout for 20 years on allopurinol and colchicine. He was seen in
consultation for deforming polyarthritis of the small and large joints, which
had been evolving for about 2 years. The acute episode occurred 10 days earlier
with the onset of bilateral and symmetrical polyarthritis affecting the large
and small joints. The physical examination revealed a peripheral joint syndrome
with ulnar gale force deformities of the hands and several buttonhole
deformities of the fingers. In addition, there were nodules, some of which were
fistulised, giving rise to a chalky slurry. The biology revealed an
inflammatory syndrome in addition to rheumatoid factors and ACPA, which were
elevated. Biological analysis of the nodular fluid revealed clusters of sodium
urate crystals and ultrasound scans of the joints revealed a double-contour
appearance in several joints. The diagnosis of RA was made using the 2010
ACR/EULAR criteria. The patient was treated as an outpatient with
corticosteroids before being put on methotrexate. It is important to understand
that these two conditions can occur at the same time, so it is important to
consider them when treating patients with gout or RA.