G.R. GAINULLINA¹, M.A. AFANASYEVA², S.A. LAPSHINA¹

¹Kazan State Medical University, 49 Butlerov Str., Kazan, Russian Federation, 420012

²Republic Clinical Hospital, 138 Orenburgskiy trakt, Kazan, Russian Federation, 420064

Gainullina G.R. — resident of the Department of Hospital Therapy, tel. (843) 231-21-67, e-mail: nice.gaynullina@bk.ru

Afanasyeva M.A. — rheumatologist of the Rheumatology Unit, tel. (843) 231-21-67, e-mail: afmaria2108@mail.ru

Lapshina S.A. — PhD (medicine), Assistant Lecturer of the Department of Hospital Therapy, tel. (843) 237-34-83, e-mail: svetlanalapshina@mail.ru

Gout usually affects middle-aged and senior people, mainly men. Women of childbearing age rarely have primary gout, which is due to the pronounced uricosuric effect of estrogens. Women with anorexia are an exception. It has been shown that such patients may have hyperuricemia. However multiple tophaceous gout rarely develops in them. To the best of our knowledge, only nine such cases have been reported in the English-language medical published works. In these patients, gout was considered to be secondary to abuse of diuretics, laxatives or self-induced vomiting, and alcohol. The paper describes a case of severe gout in a young woman as a result of a prolonged eating disorder. Her anamnesis includes using various dietary supplements for weight loss, fasting, and habitual self-induced vomiting. Severe gout developed as a result. The patient’s condition improved with glucocorticoid therapy. However, its immunosuppressive effect, combined with immunity decrease in anorexia, led to manifestation of opportunistic infection — tuberculosis.

Key words: gout, anorexia, tuberculosis, diagnosis, treatment.

(For citation: Gainullina G.R., Afanasyeva M.A., Lapshina S.A. Severe gout in a young woman as a result of eating disorder: A case report. Practical Medicine. 2018)

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