Secondary gout from myelofibrosis

Case contributed by Dr Jayanth Keshavamurthy

Patient Data

Age: 75
Gender: Female
X-ray

Name the arthritis?

Findings:

  • There is diffuse soft tissue swelling.
  • There is no decreased mineralization of the juxta articular and periarticular carpal and metacarpal bones.
  • There are punched out erosive changes involving the base of the right first metacarpal with overhanging sclerotic edges.
  • No joint narrowing.
  • These findings are extremely concerning for gouty arthritis.


 

Case Discussion

74-year-old AAF with past medical history significant for
myelofibrosis diagnosed
5years ago (JAK2V17F positive) 
taking Ruxolitinib 20mg BID , severe pulmonary hypertension,
 thrombocytosis, chronic
anemia, history of TIA who presented with complaints of right hand
swelling, warmth and pain after receiving blood transfusion. 

She was seen in the hematology clinic and was sent for
a 2 unit blood transfusion.  The patient states that since
this blood transfusion she has had pain, swelling, redness and warmth
at the site on her right hand. Interestingly, the patient was
documented by nursing to have received the transfusion in the left hand. 

Uric acid was checked and was more than twice normal at 12.8 mg/dl.

She was discharged home on colchicine 0.6 mg bid.

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Case information

rID: 43998
Case created: 1st Apr 2016
Last edited: 7th Aug 2017
Inclusion in quiz mode: Included

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