Genetic Background of a Juvenile Onset Gout Patient

Lumbosacral Paravertebral Tophaceous Gout on an Adolescent Mimicking Malignant Neoplasm in 18F-FDG PET/CT

“…7,8 In addition, it is noteworthy that, although gout and gouty tophus are more commonly seen in middle-aged and elderly individuals with hyperuricemia, however, the incidence is increasing in children and adolescents due to the increase in intake of high-purine and high-protein diets. 9,10 To our known, this is the first reported case of spinal gouty tophus in an adolescent without prior medical or familial history, as visualized on 18 F-FDG PET/CT imaging. [11][12][13][14] Therefore, it is needed to be aware about the possibility of gouty tophus, when an 18 F-FDG-avid mass with mixed density is found in the spine of an adolescent without relevant medical or familial history.…”

“…Because of macrophages and various proinflammatory cytokines and the chronic inflammatory granulomatous reaction induced by monosodium urate crystals, gouty tophus shows high 18 F-FDG uptake on PET/ CT, even accompanied by bone erosion and destruction, making it difficult to distinguish from vertebral tuberculosis, tumors from mesenchymal tissues, vertebrae, and so on 7,8. In addition, it is noteworthy that, although gout and gouty tophus are more commonly seen in middle-aged and elderly individuals with hyperuricemia, however, the incidence is increasing in children and adolescents due to the increase in intake of high-purine and high-protein diets 9,10. To our known, this is the first reported case of spinal gouty tophus in an adolescent without prior medical or familial history, as visualized on 18 F-FDG PET/CT imaging [11][12][13][14].…”