Rasburicase for tophaceus gout treatment
Ribeiro, A.; Bogas, M.ón.; Costa, J.é; Costa, L.úc.; Araújo, D.
Acta Reumatologica Portuguesa 34(3): 551-554
2009
ISSN/ISBN: 2184-8777 PMID: 19820680 Document Number: 628709
The main obstacle to the treatment of hyperuricemia in patients with allergy to allopurinol is the limited availability of equally efficient alternative drugs. The authors present a clinical case of a patient with incapacitant tophaceus gout, allergy to allopurinol and contraindication for uricosurics, who was treated with rasburicase, an urato-oxidase recombinant, based on experience with this drug in tumoral lisis and in some cases reports of tophaceus gout. The authors also enhance the fact of being a patient with a sequelar hemiplegia of a previous cerebrovascular disease that presents tophus only in the not paretic member. The management of patients with allergy to allopurinol can be a clinical challenge, and the monthly rasburicase perfusions may be an alternative treatment of serious gout not treatable for other ways.