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原发性痛风近年有增多趋势,以肾损害为突出表现者每易误诊。今遇3例报告如下。例1,男性,66岁。因四肢关节疼痛变形、活动障碍二十年,加重二月伴腰痛浮肿入院。患者近二十年来四肢小关节疼痛。发作时双肘关节肿胀变形,缓解后可正常活动,多次外院检查拟“类风湿性关节炎”而症状反复。二月来症状加重,腰酸、双睑浮肿。门诊化验血Cr、尿酸均增高,拟“痛风、尿酸性肾病”收治。体检:贫血貌,双睑浮肿,左右肘、右耳廓可及4×3×2～2×1×1cm~3之结节,质中等,活动度差,无压痛。左脊肋角叩击痛(+),尿蛋白(-)～(±),RBC(+),WBC 少许,血Cr300μmmol/1,BUN12.75mmol
Primary gout in recent years, an increasing trend to kidney damage as a manifestation of each misdiagnosis. Today, three cases are reported as follows. Example 1, male, 66 years old. Due to the pain in the limbs, deformation, movement disorders for 20 years, increased in February with low back pain edema hospitalization. Patients with limb pain in the past two decades. Elbow attack when the onset of swelling and deformation, remission can be normal activities, many times outside the hospital to check the “rheumatoid arthritis” and the symptoms repeated. In February to increase the symptoms, backache, double eyelid edema. Clinical laboratory blood Cr, uric acid were higher, to be “gout, uric acid nephropathy” admitted. Physical examination: anemia appearance, double eyelid edema, left and right elbow, right auricle and 4 × 3 × 2 ~ 2 × 1 × 1cm ~ 3 nodules, medium quality, poor mobility, no tenderness. (+), Urinary protein (-) ~ (±), RBC (+), a little WBC, blood Cr300μmmol / 1, BUN12.75mmol