Published online Aug 16, 2022. doi: 10.12998/wjcc.v10.i23.8224
Peer-review started: June 8, 2021
First decision: July 15, 2021
Revised: July 27, 2021
Accepted: July 8, 2022
Article in press: July 8, 2022
Published online: August 16, 2022
Processing time: 419 Days and 1.7 Hours
Gouty tophi are a chronic granulomatous caused by a deposition of monosodium urate crystal deposition in the body. Once broken, it may easily induce severe infection. Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting, and no such serious complications have been reported in literature.
This is a 52-year-old Chinese male patient with a 20-year history of gouty arthritis. At admission, the gout stone in the patient’s right ankle was broken and it secreted a white mucoid substance. During the course of treatment, the patient suffered from systemic inflammatory response syndrome multiple times. His condition gradually deteriorated, further complicated by hemophagocytic syndrome. After thorough removal of gout lesions and active anti-infection treatment and control of blood uric acid level, combined with multidisciplinary cooperation, the patient was finally cured.
Sepsis complicated with secondary hemophagocytic syndrome induced by gouty tophi rupture is extremely rare in the clinical setting. Timely and accurate diagnosis is very important to save patients' lives.
Core Tip: Sepsis and secondary hemophagocytic syndrome induced by gouty tophi rupture are very rare in a clinical setting. Since the early symptoms are similar to gouty arthritis, it is easy to ignore septic infection and immune system damage. Sepsis and hemophagocytic syndrome develop rapidly. Often, when detected by clinicians, patients have life-threatening symptoms. This case emphasizes that clinicians should screen patients with gouty tophi rupture for early complications of sepsis and immune system damage. It is, therefore, important to improve the relevant examination as soon as possible and initiate early intervention.