Lai B, Pang ZH. Sepsis complicated with secondary hemophagocytic syndrome induced by giant gouty tophi rupture: A case report. World J Clin Cases 2022; 10(23): 8224-8231 [PMID: 36159520 DOI: 10.12998/wjcc.v10.i23.8224]
Corresponding Author of This Article
Zhi-Hui Pang, MD, Chief Physician, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 12 Airport Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. adi_007@126.com
Research Domain of This Article
Rheumatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Aug 16, 2022; 10(23): 8224-8231 Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8224
Sepsis complicated with secondary hemophagocytic syndrome induced by giant gouty tophi rupture: A case report
Bin Lai, Zhi-Hui Pang
Bin Lai, The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Zhi-Hui Pang, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
Author contributions: Both authors were involved in the treatment and case of the patient; Lai B collected the patient’s data and wrote the initial draft of the manuscript; Pang ZH critically appraised and revised the overall content of the manuscript; All authors read and approved the final manuscript.
Supported bythe National Natural Science Foundation of China, No. 81774336 (to Pang ZH).
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Hui Pang, MD, Chief Physician, Department of Orthopedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, No. 12 Airport Road, Baiyun District, Guangzhou 510405, Guangdong Province, China. adi_007@126.com
Received: June 8, 2021 Peer-review started: June 8, 2021 First decision: July 15, 2021 Revised: July 27, 2021 Accepted: July 8, 2022 Article in press: July 8, 2022 Published online: August 16, 2022
Abstract
BACKGROUND
Gouty tophi are a chronic granulomatous caused by a deposition of monosodium urate crystal deposition in the body. Once broken, it may easily induce severe infection. Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting, and no such serious complications have been reported in literature.
CASE SUMMARY
This is a 52-year-old Chinese male patient with a 20-year history of gouty arthritis. At admission, the gout stone in the patient’s right ankle was broken and it secreted a white mucoid substance. During the course of treatment, the patient suffered from systemic inflammatory response syndrome multiple times. His condition gradually deteriorated, further complicated by hemophagocytic syndrome. After thorough removal of gout lesions and active anti-infection treatment and control of blood uric acid level, combined with multidisciplinary cooperation, the patient was finally cured.
CONCLUSION
Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting. Timely and accurate diagnosis is very important to save patients' lives.
Core Tip: Sepsis and secondary hemophagocytic syndrome induced by gouty tophi rupture are very rare in a clinical setting. Since the early symptoms are similar to gouty arthritis, it is easy to ignore septic infection and immune system damage. Sepsis and hemophagocytic syndrome develop rapidly. Often, when detected by clinicians, patients have life-threatening symptoms. This case emphasizes that clinicians should screen patients with gouty tophi rupture for early complications of sepsis and immune system damage. It is, therefore, important to improve the relevant examination as soon as possible and initiate early intervention.
