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Severe gouty arthritis refractory to anti-inflammatory drugs: treatment with anti-tumour necrosis factor α as a new therapeutic option
  1. A K Tausche,
  2. K Richter,
  3. A Grässler,
  4. S Hänsel,
  5. B Roch,
  6. H E Schröder
  1. Section of Internal Medicine, Department of Rheumatology, University Clinic Carl Gustav Carus, Dresden University of Technology, Fetscherstrasse 74, D- 01307 Dresden, Germany
  1. Correspondence to:
    Dr A K Tausche;

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We report the case of a 53 year old man with a history of gouty arthritis extending over several years. He had had an acute kidney failure 2 years previously because of nephrolithiasis with urate calculi.


At the first consultation the patient had severe painful gouty arthritis (three to four attacks a week) of the joints of the big toes, the ankle joints, and different finger joints as well as in joints of the hands, shoulders, and knees. In addition to the polyarticular joint manifestation, multiple gouty tophi were present in the subcutaneous tissue (fig 1).

Figure 1

 Clinical image of the right foot showing gouty arthritis with extreme swelling, erythema, and tophi.

The medical history of the patient showed he had arterial hypertension and hypertriglyceridaemia. He consumed 20–25 units of alcohol weekly. …

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