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一般认为继发性高尿酸血症很少引起痛风,兹报道一例慢性中性粒细胞性白血病(CNL)伴高尿酸血症,而以痛风为突出表现的病例。李某,男性,63岁。因两侧内踝红肿热痛一个月,逐渐加剧.至不能行走,于1985年3月7日入院.发病以来曾多次检查血象,白细胞数波动在27.5～52.0×10~9/L,嗜中性为0.9～0.95,故曾反复应用多种抗生素,疗效不明显.二年来有发作性右上腹胀痛,与饮食无关,曾抑诊为“胆囊炎”。体检:体温36.7℃,皮肤,粘膜未见瘀点。浅表淋巴结无肿大.心肺(一),肝在右肋下2.5cm,脾在左助下7.0cm.两侧内踝关节肿胀稍充血,以右侧为重,伴压痛.化验:H b97g/L,网织红细胞
It is generally accepted that secondary hyperuricemia rarely causes gout. One case of chronic neutrophilic leukemia (CNL) with hyperuricemia is reported, with gout prominent. Lee, male, 63 years old. Due to swelling of the medial malleolus on both sides of heat pain for a month, gradually aggravating .To not walk, was admitted to hospital on March 7, 1985. Since the onset of multiple blood tests, the number of white blood cells fluctuated between 27.5 ~ 52.0 × 10 ~ 9 / L, Sex is 0.9 ~ 0.95, so it has repeatedly applied a variety of antibiotics, curative effect is not obvious .Two years have episodes of right upper quadrant pain, has nothing to do with diet, once diagnosed as “cholecystitis.” Physical examination: body temperature 36.7 ℃, skin, mucous membrane no petechia. Superficial lymph nodes without swelling. Cardiopulmonary (a), the liver in the right rib 2.5cm, the spleen in the left help 7.0cm. Ankle swelling on both sides of a little hyperemia, right to weight, with tenderness. Hb97g / L, reticulocytes