Paraparesia por gota

Ferreira, Adelmo; Silva Jr, Bonfim Alves; Braga, F. Menezes; Gargiulo, Núbia M. Noschese; Stávale, J. Norberto

doi:10.1590/S0004-282X1989000400017

Resumos

Os autores apresentam um caso de bloqueio de canal raquidiano por tofo em paciente de 23 anos de idade com gota tofácea crônica e artrite gotosa, que desenvolveu paraparesia crural. Submetido a laminectomia, com exérese de acúmulos de cristais junto ao ligamento amarelo, não houve melhora do déficit motor. A revisão da literatura mostrou 9 casos previamente relatados.

A case of a 23 year-old-man with a history of polyarthritis and chronic tophaceous gout is reported. He developed a crural paraparesis caused by sodium urate deposits in the spinal canal. Decompressive laminectomy and removal of urate-laden liga-mentum flavum was performed without improvement. According to the literature there are nine cases previously reported.

Paraparesia por gota

Paraparesis in gout

Adelmo Ferreira^I; Bonfim Alves Silva Jr.^II; F. Menezes Braga^III; Núbia M. Noschese Gargiulo^IV; J. Norberto Stávale^V

^IHospital Municipal Arthur Ribeiro de Saboya (HMARS) e Escola Paulista de Medicina (EPM): Pós-Graduando em Neurocirurgia EPM, Médico do Serviço de Neurocirurgia (SN) HMARS

^IIHospital Municipal Arthur Ribeiro de Saboya (HMARS) e Escola Paulista de Medicina (EPM): Pós-Graduando em Fisiologia Humana no Instituto de Ciências Biomédicas da Universidade de São Paulo, Médico do SNHMARS

^IIIHospital Municipal Arthur Ribeiro de Saboya (HMARS) e Escola Paulista de Medicina (EPM): Professor Adjunto de Neurocirurgia, Chefe da Disciplina de Neurocirurgia e Coordenador do Curso de Pós-Graduação em Neurocirurgia, EPM

^IVHospital Municipal Arthur Ribeiro de Saboya (HMARS) e Escola Paulista de Medicina (EPM): Médica do SNHMARS

^VHospital Municipal Arthur Ribeiro de Saboya (HMARS) e Escola Paulista de Medicina (EPM): Professor Adjunto da Disciplina de Anatomia Patológica, EPM

RESUMO

Os autores apresentam um caso de bloqueio de canal raquidiano por tofo em paciente de 23 anos de idade com gota tofácea crônica e artrite gotosa, que desenvolveu paraparesia crural. Submetido a laminectomia, com exérese de acúmulos de cristais junto ao ligamento amarelo, não houve melhora do déficit motor. A revisão da literatura mostrou 9 casos previamente relatados.

SUMMARY

A case of a 23 year-old-man with a history of polyarthritis and chronic tophaceous gout is reported. He developed a crural paraparesis caused by sodium urate deposits in the spinal canal. Decompressive laminectomy and removal of urate-laden liga-mentum flavum was performed without improvement. According to the literature there are nine cases previously reported.

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Dr. Adelmo Ferreira - Av. 11 de Junho 911, apto. 705 - 04041 São Paulo SP - Brasil.

1. Aaron SL, Miller JDR, Percy JS - Tophaceous gout in the cervical spine. J Rheumatol 11: 862, 1984.
2. Hall MC, Selin G - Spinal involvement in gout: a case report with autopsy. J Bone Joint Surg 42A: 341, 1960.
3. Kelley WN, Fox IH - Gout and related disorders of purine metabolism. In Kelley WN, Harris JR. Ruddy S, Sledge CB (eds): Textbook of Rheumatology. Ed 2. Saunders, Philadelphia, pg 1359.
4. Kersley GD, Mandel L, Jeffrey MR - Gout: an unusual case with softening and subluxation of the first cervical vertebra and splenomegalia. Ann Rheum Dis 9: 282, 1950.
5. Koskoff YD, Morris US, Lubic LG - Paraplegia as a complication of gout. J Am Med Assoc 152: 37, 1953.
6. Liechtenstein L, Scott HW, Levin MH - Pathologic changes in gout: survey of eleven necropsied cases. Am J Pathol 32: 871, 1956.
7. Litvak J, Briney W - Extradural spinal depositions of urates producing paraplegia: case report. J Neurosurg, 39:656, 1973.
8. Magid SK, Gray GE, Anand A - Spinal cord compression by tophi in a patient with chronic polyarthritis: case report and literature review. Arthr Rheum 24: 1431, 1981.
9. Malawista SE, Seegmiller JE, Hathway BE, Sokoloff L - Sacroiliac gout. J Am Med Assoc 194: 106, 1965.
10. Reynolds AF Jr, Wyler AR, Norris HT - Paraparesis secondary to sodium urate deposits in the ligamentum flavum. Arch Neurol 33: 795, 1976.
11. Sass JK, Itabashi HH, Dexter RA - Juvenile gout with brain involvement. Arch Neurol 13: 639, 1965.
12. Sequeira W, Bouffard A, Salgia K, Skosey J - Quadriparesis in tophaceous gout. Arthr Rheum 24: 1428, 1981.
13. van de Laar MAFJ, van Soesbergen RM, Matricali B - Tophaceous gout of the cervical spine without peripheral tophi. Arthr Rheum 30: 237, 1987.
14. Varga J, Giampaolo C, Goldenberg DL - Tophaceous gout of the spine in a patient with no peripheral tophi: case report and review of the literature. Arthr Rheum 28: 1312, 1985.
15. Vinstein AL, Cockerill EM - Involvement of the spine in gout: a case report. Radiology 103: 311, 1972.

Datas de Publicação

Publicação nesta coleção
01 Jun 2011
Data do Fascículo
Dez 1989

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. Aaron SL, Miller JDR, Percy JS - Tophaceous gout in the cervical spine. J Rheumatol 11: 862, 1984.

[2] 2. Hall MC, Selin G - Spinal involvement in gout: a case report with autopsy. J Bone Joint Surg 42A: 341, 1960.

[3] 3. Kelley WN, Fox IH - Gout and related disorders of purine metabolism. In Kelley WN, Harris JR. Ruddy S, Sledge CB (eds): Textbook of Rheumatology. Ed 2. Saunders, Philadelphia, pg 1359.

[4] 4. Kersley GD, Mandel L, Jeffrey MR - Gout: an unusual case with softening and subluxation of the first cervical vertebra and splenomegalia. Ann Rheum Dis 9: 282, 1950.

[5] 5. Koskoff YD, Morris US, Lubic LG - Paraplegia as a complication of gout. J Am Med Assoc 152: 37, 1953.

[6] 6. Liechtenstein L, Scott HW, Levin MH - Pathologic changes in gout: survey of eleven necropsied cases. Am J Pathol 32: 871, 1956.

[7] 7. Litvak J, Briney W - Extradural spinal depositions of urates producing paraplegia: case report. J Neurosurg, 39:656, 1973.

[8] 8. Magid SK, Gray GE, Anand A - Spinal cord compression by tophi in a patient with chronic polyarthritis: case report and literature review. Arthr Rheum 24: 1431, 1981.

[9] 9. Malawista SE, Seegmiller JE, Hathway BE, Sokoloff L - Sacroiliac gout. J Am Med Assoc 194: 106, 1965.

[10] 10. Reynolds AF Jr, Wyler AR, Norris HT - Paraparesis secondary to sodium urate deposits in the ligamentum flavum. Arch Neurol 33: 795, 1976.

[11] 11. Sass JK, Itabashi HH, Dexter RA - Juvenile gout with brain involvement. Arch Neurol 13: 639, 1965.

[12] 12. Sequeira W, Bouffard A, Salgia K, Skosey J - Quadriparesis in tophaceous gout. Arthr Rheum 24: 1428, 1981.

[13] 13. van de Laar MAFJ, van Soesbergen RM, Matricali B - Tophaceous gout of the cervical spine without peripheral tophi. Arthr Rheum 30: 237, 1987.

[14] 14. Varga J, Giampaolo C, Goldenberg DL - Tophaceous gout of the spine in a patient with no peripheral tophi: case report and review of the literature. Arthr Rheum 28: 1312, 1985.

[15] 15. Vinstein AL, Cockerill EM - Involvement of the spine in gout: a case report. Radiology 103: 311, 1972.