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痛风的神经系统并发症少见,作者报告一例痛风具有高尿酸血症产生可逆性周围神经病。患者53岁、男性,患慢性痛风和肾结石,6个月以来进行性两足麻木及步行困难。否认嗜酒、糖尿病、接触毒物史,无痛风或神经病的家族史。他不规则地服用秋水仙素和别嘌呤醇。四肢有多发性痛风石。步态宽,Romberg 征阳性。两臂腱反射降低,两下肢腱反射消失。胫前肌及屈趾短肌肌力轻度减退,未见肌萎缩。四肢远端震动觉、位置觉和轻触觉明显减退。右手出现腕管综合征(CTS)。血清尿酸10.1mg%(正常3.5—8.5mg%),CSF 正常。未发现潜在的肿瘤。神经传导速度(NCS)符合神经轴索病变和右侧 CTS。将别嘌呤醇增至200mg2/日。6个月后自觉症状明显好转,许多痛风石消退,膝反射恢复,但仍较弱,肌力和步态恢复正常,感觉也明显好转,腕管综合征消失。3年后因急性肾绞痛而作肾结石
Nervous system complications of gout are rare, the authors report a case of gout with hyperuricemia produce reversible peripheral neuropathy. 53-year-old man, suffering from chronic gout and kidney stones, two-legged numbness and walking difficulties since 6 months. Denied alcohol abuse, diabetes, exposure to poison history, family history of no gout or neuropathy. He takes colchicine and allopurinol irregularly. Multiple limbs have toothache. Gait wide, Romberg sign positive. Tendons tendon reflex decreased, the lower extremity tendon reflex disappeared. Muscle strength of anterior tibialis anterior muscle and flexor toe were decreased slightly, no muscular atrophy was observed. Distracted limbs vibration, position perception and touch decreased significantly. Right hand carpal tunnel syndrome (CTS). Serum uric acid 10.1mg% (normal 3.5-8.5mg%), normal CSF. No potential tumor found. Nerve conduction velocity (NCS) is consistent with axonal lesions and right CTS. Allopurinol was increased to 200 mg2 / day. 6 months after the symptoms significantly improved, many toe stone regression, knee reflex recovery, but still weak, muscle strength and gait returned to normal, the feeling is also significantly improved, carpal tunnel syndrome disappeared. 3 years after renal stones due to acute renal colic