Chronic Tophaceous Gout Secondary to Self-Induced Vomiting in Anorexia Nervosa

In 2010, a case study was reported of a 50-year-old Japanese woman with a history of anorexia nervosa (AN) who developed chronic tophaceous gout, a condition characterized by the deposition of urate crystals in tissues. The patient had a history of hyperuricemia, acute renal failure, and hypokalemia, and presented with painful erythema, swelling, and nodular masses on various joints. Laboratory analyses confirmed renal insufficiency and hyperuricemia, and treatment with medications including allopurinol and etodolac improved her symptoms. The study suggested that her gout was a late manifestation of AN, exacerbated by self-induced vomiting leading to hypokalemia and reduced renal uric acid clearance. This case was notable as gout is rare in premenopausal women and is not a well-recognized complication of AN. The study concluded that gout should be considered in the list of complications for AN, and skin lesions such as tophi may indicate underlying eating disorders.