Gout successfully treated with diet and benzbromarone in a living kidney donor

Abstract

Objective: To describe a patient with gout initiated after living kidney donation successfully treated with benzbromarone. Case Presentation: A 53 years old male with no previous history of prior illness who donated his left kidney to his father. Nine years after the surgical procedure, he had a podagra, and the arthritis progressed to other joints on evolution. He received allopurinol 300 mg/day plus colchicine 1 mg/day. He returned to our clinic 6 years later, referring to high alcoholic ingestion, especially beer on the weekend and using colchicine. His physical examination showed a podagra, but no tophi were noted. Laboratory tests revealed uric acid of 9.2 mg/dL (nr: < 7 mg/dL), 24 hours urinary uric acid (UUA) of 220 mg (nr: 25-750 mg/day), and C-reactive protein (CRP) was 8.3 mg/dL (nr: < 3 mg/dL). Benzbromarone colchicine, besides increased oral hydration to 3 liters/day, a hypocaloric diet, and stopping alcohol drinking were prescribed. After three months, he denied arthritis; his uric acid was reduced to 5.1 mg/dL, and UUA increased to 590 mg in 24 hours. After one year of treatment, he is asymptomatic, without alcoholic drinks, has normal inflammatory markers, hIs uric acid is 4.8 mg/dL, and uses only benzbromarone 100 mg/day. No side effect related to benzbromarone was observed in our patient. Conclusions: To the best of our knowledge, this is the first case illustrating a patient with gout after a living kidney transplant successfully treated with diet and benzbromarone.

Keywords

• gout
• arthritis
• renal diseases
• kidney transplant
• transplantation
• benzbromarone