A Chronic Untreated Tophaceous Gout with Dilated Cardiomyopathy and Chronic Kidney Disease: A Rare Case Report

Abstract

Gout is the most prevalent inflammatory arthropathy in men caused by elevated serum uric acid levels. This article presents a case study of a 40-year-old male patient with chronic untreated gout exhibited as decompensated global dilated cardiomyopathy, painful nodular joints in the hands and feet, pitting pedal edema, elevated JVP, and crepitations in lower lung fields. Laboratory tests revealed high levels of NT-ProBNP, serum uric acid, azotemia. Echocardiography showed dilated ventricles with ejection fraction of 32%. X-ray images showed punched-out bony erosions in the joints of hands. Although there is substantial evidence indicating that uric acid may be an indicator of cardiovascular diseases, it has not been conclusively proven that hyperuricemia is a causative factor. Though it is uncommon, more studies are necessary to investigate the correlation between the severity of gout and heart failure. This case highlights the importance of regulating urate concentration in patients with gout.

Keywords

• gout
• dilated cardiomyopathy
• hyperuricemia
• chronic kidney disease