A case of hypopituitarism and gout in a female patient

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We report a 31-year-old female with hypopituitarism complicated with gout. She had received an operation for craniopharyngioma and an irradiation therapy at 11 years of age. At the age of 29 years, the patient visited the hospital with complaints of easy fatigability and edema. She was diagnosed as having hypopituitarism, diabetes insipidus and hypogonadism. The serum uric acid level (UA) was 9.5mg/dl. Therapy consisting of thyroid hormone, hydrocortisone, DDAVP and allopurinol was begun. However, she did not properly take allopurinol. At the age of 31 years, she was admitted to the hospital because of high fever with severe pain, redness and swelling on the back of her left foot. Laboratory data showed serum UA 11.7mg/dl, Cr 1.7mg/dl, and CUA/Ccr 6.7%. No abnormalities were found in renal computerized tomography and intravenous pyelography. The laboratory findings and the clinical course suggested that the suppression of urinary excretion of uric acid was the primary cause of hyperuricemia.<BR>To our knowledge, this is the first report of hypopituitarism complicated with gout. Some investigators have reported that estrogen accelerates urinary excretion of uric acid, while others the decreased level of FSH, LH and estradiol in gouty patients of both sexes.<BR>These findings suggest a close relationship between sex hormones and the metabolism of uric acid. Therefore, the present case suggests that a deficiency of female sex hormone induces hyperuricemia and gout.
Japanese Society of Gout and Nucleic Acid Metabolismの論文

A case of hypopituitarism and gout in a female patient

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