Published in:
01-06-2016 | Case Report
“Unusual Cause Of Tophi With Renal Thrombotic Microangiopathy”
Authors:
Kamal Kant Sahu, Arjun Datt Law, Ganesh Kumar, Varun Dhir, Shano Naseem, Ritambhra Nada, Subhash Chander Varma, Pankaj Malhotra
Published in:
Indian Journal of Hematology and Blood Transfusion
|
Special Issue 1/2016
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Abstract
Chronic neutrophilic leukemia (CNL) is a rare entity amongst myeloproliferative neoplasms (MPNs). The classical presentation of CNL is with splenomegaly, mature neutrophilic leucocytosis and hyperuricemia. We herein report a case who presented with symptoms of acute gouty arthritis. Physical examination showed typical red, tender tophi in the right hand, right foot and both pinnae suggesting an acute episode of gout. During evaluation, moderate splenomegaly, mature neutrophilia, hyperuricemia and sub-nephrotic range range proteinuria were noted. Bone marrow examination and kidney biopsy was done. Final diagnosis of CNL with acute gouty arthritis and chronic renal thrombotic microangiopathy (TMA) was made. Although hyperuricemia is a common finding in MPNs but presentation of our case with symptoms of acute tophi and chronic TMA is atypical.