avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2021-11-2-154-160avk-1175Research ArticleРАЗБОР КЛИНИЧЕСКИХ СЛУЧАЕВANALYSIS OF CLINICAL CASESТофусная подагра как причина синдрома запястного канала и дисфункции сухожилий сгибателей кистиTophaceous Gout Causing the Carpal Tunnel Syndrome and Flexor Digitorum Dysfunction: A Case Reporthttps://orcid.org/0000-0003-2182-1134КулаковД. Ю.KulakovD. Y.

Москва

Moscow

https://orcid.org/0000-0002-4262-4060ЛялинаВ. В.LyalinaV. V.

Вера Валерьевна Лялина

Москва

Vera V. Lyalina

Moscow

vera_lyalina@mail.ruhttps://orcid.org/0000-0001-6321-8419СкрипниченкоЭ. А.SkripnichenkoE. A.

Москва

Moscow

ПриписноваС. Г.PripisnovaS. G.

Москва

Moscow

МаксимовА. А.MaksimovA. A.

Москва

https://orcid.org/0000-0003-2914-318XШехтерА. Б.ShehterA. B.

Москва

Moscow

https://orcid.org/0000-0003-1699-0881НикитинИ. Г.NikitinI. G.

Москва

Moscow

Кафедра госпитальной терапии № 2 лечебного факультета ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава РоссииРоссияInternal Diseases 2nd Department, Pirogov Medical UniversityRussian FederationКлиника «Ортоспайн»РоссияOrthospine ClinicRussian FederationГБУЗ «ГКБ им. С.С. Юдина ДЗМ»РоссияYudin State Clinical Hospital of MoscowRussian FederationЛаборатория экспериментальной морфологии Института регенеративной медицины Научно-технологического парка биомедицины, ФГАОУ ВО Первый МГМУ им. И.М. Сеченова Минздрава России (Сеченовский Университет)РоссияInstitute for Regenerative Medicine, Sechenov UniversityRussian Federation202130032021112154160Copyright © Кулаков Д.Ю., Лялина В.В., Скрипниченко Э.А., Приписнова С.Г., Максимов А.А., Шехтер А.Б., Никитин И.Г., 20212021Кулаков Д.Ю., Лялина В.В., Скрипниченко Э.А., Приписнова С.Г., Максимов А.А., Шехтер А.Б., Никитин И.Г.Kulakov D.Y., Lyalina V.V., Skripnichenko E.A., Pripisnova S.G., Maksimov A.A., Shehter A.B., Nikitin I.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1175

Синдром запястного канала — самая частая периферическая компрессионная мононейропатия, к развитию которой может приводить множество заболеваний и состояний, в том числе, формирование подагрических тофусов в различных структурах канала. В публикации приведен обзор литературы и описание клинического случая синдрома запястного канала у пациента 58 лет с тофусной подагрой и неконтролируемой гиперурикемией. Особенностью случая является сочетание компрессионной нейропатии срединного нерва и дисфункции сухожилий сгибателей пальцев кисти в результате тофусного поражения.

Carpal tunnel syndrome is the most common peripheral compression neuropathy and can be caused by many diseases and conditions, including the formation of gouty tophi in various structures of the tunnel. This publication provides a review of literature and a case report on Carpal tunnel syndrome in a 58-year-old male patient with tophaceous gout. The case is characterized by the extremely rare combination of median nerve compression and tendons dysfunction due to the tophi deposits in the flexor tendons of the hand.

синдром запястного каналатофусная подагратофусная тендопатиякомпрессионная нейропатияхирургическая декомпрессия срединного нервавнутрисухожильные тофусыcarpal tunnel syndrometophaceous gouttophaceous tendinopathycompression neuropathysurgical decompression of the median nervehistological presentation of intratendinous tophiReferencesMani B., Sarawagi R., Cherian R.A. Review of the dimensions of the median nerve and carpal tunnel using sonography in asymptomatic adults. Journal of Medical Imaging and Radiation Oncology. 2011;55(2):126-131. doi:10.1111/j.1754-9485.2010.02225.xMani B., Sarawagi R., Cherian R.A. Review of the dimensions of the median nerve and carpal tunnel using sonography in asymptomatic adults. Journal of Medical Imaging and Radiation Oncology. 2011;55(2):126-131. doi:10.1111/j.1754-9485.2010.02225.xЛялина В.В., Сторожаков Г.И. Грамматика артрита.: Практика.2010;143 с.Лялина В.В., Сторожаков Г.И. Грамматика артрита.: Практика.2010;143 с.Kothari M.J. Carpal tunnel syndrome: Clinical manifestations and diagnosis. 2020. [Electronic resource] URL: https://www.uptodate.com/contents/carpal-tunnel-syndrome-clinical-manifestationsand-diagnosis. (date of the application: 01.12.2020)Kothari M.J. Carpal tunnel syndrome: Clinical manifestations and diagnosis. 2020. [Electronic resource] URL: https://www.uptodate.com/contents/carpal-tunnel-syndrome-clinical-manifestationsand-diagnosis. (date of the application: 01.12.2020)Kothari M.J. Carpal tunnel syndrome: Etiology and epidemiology. 2020. [Electronic resource] URL: https://www.uptodate.com/contents/carpal-tunnel-syndrome-etiology-and-epidemiology. (date of the application: 01.12.2020)Kothari M.J. Carpal tunnel syndrome: Etiology and epidemiology. 2020. [Electronic resource] URL: https://www.uptodate.com/contents/carpal-tunnel-syndrome-etiology-and-epidemiology. (date of the application: 01.12.2020)Ashworth N.L. Carpal Tunnel Syndrome. 2020. [Electronic resource]. URL: https://emedicine.medscape.com/article/327330-overview#a6 (date of the application: 01.12.2020).Ashworth N.L. Carpal Tunnel Syndrome. 2020. [Electronic resource]. URL: https://emedicine.medscape.com/article/327330-overview#a6 (date of the application: 01.12.2020).Sestak I., Sapunar F., Cuzick J. Aromatase Inhibitor-Induced Carpal Tunnel Syndrome: Results From the ATAC Trial.Journal of Clinical Oncology.2009;27(30):4961-4965. doi: 10.1200/JCO.2009.22.0236.Sestak I., Sapunar F., Cuzick J. Aromatase Inhibitor-Induced Carpal Tunnel Syndrome: Results From the ATAC Trial.Journal of Clinical Oncology.2009;27(30):4961-4965. doi: 10.1200/JCO.2009.22.0236.Владимиров С.А., Елисеев М.С., Ильиных Е.В. и др. Клинические рекомендации МЗ РФ. Подагра. 2018. [Электронный ресурс]. URL: http://cr.rosminzdrav.ru/schema/251 (дата обращения 01.12.2020).Владимиров С.А., Елисеев М.С., Ильиных Е.В. и др. Клинические рекомендации МЗ РФ. Подагра. 2018. [Электронный ресурс]. URL: http://cr.rosminzdrav.ru/schema/251 (дата обращения 01.12.2020).Vladimirov S.A., Eliseev M.S., Ilinykh E.V. and others. Clinical guidelines of the Ministry of Health of the Russian Federation. Gout. 2018. [Electronic resource]. URL: http://cr.rosminzdrav.ru/schema/251(date of treatment 12/01/2020) [In Russian].Vladimirov S.A., Eliseev M.S., Ilinykh E.V. and others. Clinical guidelines of the Ministry of Health of the Russian Federation. Gout. 2018. [Electronic resource]. URL: http://cr.rosminzdrav.ru/schema/251(date of treatment 12/01/2020) [In Russian].Bardin T. Tophi: Clinical and Biological Features. Gout; 2019.37-46 p.Bardin T. Tophi: Clinical and Biological Features. Gout; 2019.37-46 p.Ministrini S., Baronio G., Zorzi F. et al. Unusual presentation of gouty tophus in the liver with subsequent appearance in the same site of HCC: a correlate diagnosis? Case report.World Journal of Surgical Oncology.2019;17:10. doi: 10.1186/s12957-018-1546-8Ministrini S., Baronio G., Zorzi F. et al. Unusual presentation of gouty tophus in the liver with subsequent appearance in the same site of HCC: a correlate diagnosis? Case report.World Journal of Surgical Oncology.2019;17:10. doi: 10.1186/s12957-018-1546-8Arlandis M., Molina V., Vanes S. et al. Acute Respiratory Failure Due to Chronic Tophaceous Gout With Laryngeal and Bronchial Involvement: An Unusual Complication. Archivos De Bronconeumolo gia.2018;54(7):399-400. doi: 10.1016/j.arbr.2018.05.008.Arlandis M., Molina V., Vanes S. et al. Acute Respiratory Failure Due to Chronic Tophaceous Gout With Laryngeal and Bronchial Involvement: An Unusual Complication. Archivos De Bronconeumolo gia.2018;54(7):399-400. doi: 10.1016/j.arbr.2018.05.008.Iacobellis G. A rare and asymptomatic case of mitral valve tophus associated with severe gouty tophaceous arthritis.Journal of Endocrinological Investigation.2004;27(10):965-966.Iacobellis G. A rare and asymptomatic case of mitral valve tophus associated with severe gouty tophaceous arthritis.Journal of Endocrinological Investigation.2004;27(10):965-966.Shrestha S., Kamal F., Khan M.A. et al. Gouty Tophi Manifesting as a Pancreatic Foci. American Journal of the Medical Sciences. 2019;358(4):294-298. doi: 10.1016/j.amjms.2019.07.001.Shrestha S., Kamal F., Khan M.A. et al. Gouty Tophi Manifesting as a Pancreatic Foci. American Journal of the Medical Sciences. 2019;358(4):294-298. doi: 10.1016/j.amjms.2019.07.001.Katoch P., Trier-Morch S., Vyberg M. Case report: Small intestinal tophus mimicking tumour. Human Pathology: Case Reports.2014;1:2–5. doi: 10.1016/j.ehpc.2014.05.001Katoch P., Trier-Morch S., Vyberg M. Case report: Small intestinal tophus mimicking tumour. Human Pathology: Case Reports.2014;1:2–5. doi: 10.1016/j.ehpc.2014.05.001Bernad B., Narvaez J., Diaz-Torne C. et al. Clinical image: Corneal tophus deposition in gout. Arthritis and Rheumatism. 2006;54(3):1025. doi: 10.1002/art.21722.Bernad B., Narvaez J., Diaz-Torne C. et al. Clinical image: Corneal tophus deposition in gout. Arthritis and Rheumatism. 2006;54(3):1025. doi: 10.1002/art.21722.Yang C.C. L., Vagefi M.R., Davis D. et al.Gouty tophus of the upper eyelid.Ophthalmic Plastic and Reconstructive Surgery.2008;24(5):404-406. doi: 10.1097/IOP.0b013e318182a538.Yang C.C. L., Vagefi M.R., Davis D. et al.Gouty tophus of the upper eyelid.Ophthalmic Plastic and Reconstructive Surgery.2008;24(5):404-406. doi: 10.1097/IOP.0b013e318182a538.Vela P., Pascual E. An Unusual Tophus.New England Journal of Medicine.2015;372(5): E6-E6.Vela P., Pascual E. An Unusual Tophus.New England Journal of Medicine.2015;372(5): E6-E6.Sharifabad M.A., Tzeng J., Gharibshahi S. Mammary gouty tophus: A case report and review of the literature.Breast Journal.2006;12(3):263-265. doi: 10.1111/j.1075-122X.2006.00252.x.Sharifabad M.A., Tzeng J., Gharibshahi S. Mammary gouty tophus: A case report and review of the literature.Breast Journal.2006;12(3):263-265. doi: 10.1111/j.1075-122X.2006.00252.x.Ward L.E., Bickel W.H., Corbin K.B. Median neuritis (carpal tunnel syndrome) caused by gouty tophi. Journal of the American Medical Association. 1958.167(7):844-846. doi: 10.1001/jama.1958.72990240006008bWard L.E., Bickel W.H., Corbin K.B. Median neuritis (carpal tunnel syndrome) caused by gouty tophi. Journal of the American Medical Association. 1958.167(7):844-846. doi: 10.1001/jama.1958.72990240006008bJoseph M.K.C., Fu-Keung I., Tak-Chuen W. et al. Carpal Tunnel Syndrome Caused by Gout: Clinical Presentations, Surgical Findings, and Outcomes After Surgery.Journal of Orthopaedics Trauma and Rehabilitation. 2015;19(1):15-20. doi: 10.3904/kjim.2014.29.4.544Joseph M.K.C., Fu-Keung I., Tak-Chuen W. et al. Carpal Tunnel Syndrome Caused by Gout: Clinical Presentations, Surgical Findings, and Outcomes After Surgery.Journal of Orthopaedics Trauma and Rehabilitation. 2015;19(1):15-20. doi: 10.3904/kjim.2014.29.4.544Rich J.T., Bush D.C., Lincoski C.J. et al. Carpal tunnel syndrome due to tophaceous gout.Orthopedics.2004;27(8):862-863.Rich J.T., Bush D.C., Lincoski C.J. et al. Carpal tunnel syndrome due to tophaceous gout.Orthopedics.2004;27(8):862-863.Patil V.S., Chopra A. Watch out for ‘pins and needles’ in hands — it may be a case of gout.Clinical Rheumatology.2007;26(12):2185-2187. doi: 10.1007/s10067-007-0672-4.Patil V.S., Chopra A. Watch out for ‘pins and needles’ in hands — it may be a case of gout.Clinical Rheumatology.2007;26(12):2185-2187. doi: 10.1007/s10067-007-0672-4.Robbins H. Anatomical Study of the Median Nerve in the Carpal Tunnel and Etiologies of the Carpal-Tunnel Syndrome.J Bone Joint Surg Am. 1963;45:953-66.Robbins H. Anatomical Study of the Median Nerve in the Carpal Tunnel and Etiologies of the Carpal-Tunnel Syndrome.J Bone Joint Surg Am. 1963;45:953-66.Weinzweig J., Fletcher J.W., Linburg R.M. Flexor tendinitis and median nerve compression caused by gout in a patient with rheumatoid arthritis.Plastic and Reconstructive Surgery.2000;106(7):1570-1572. doi: 10.1097/00006534-200012000-00019.Weinzweig J., Fletcher J.W., Linburg R.M. Flexor tendinitis and median nerve compression caused by gout in a patient with rheumatoid arthritis.Plastic and Reconstructive Surgery.2000;106(7):1570-1572. doi: 10.1097/00006534-200012000-00019.Mockford B.J., Kincaid R.J., Mackay I. Carpal tunnel syndrome secondary to intratendinous infiltration by tophaceous gout. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.2003;37(3):186-187. doi: 10.1080/02844310310007827.Mockford B.J., Kincaid R.J., Mackay I. Carpal tunnel syndrome secondary to intratendinous infiltration by tophaceous gout. Scandinavian Journal of Plastic and Reconstructive Surgery and Hand Surgery.2003;37(3):186-187. doi: 10.1080/02844310310007827.Tsai C.Y., Yu C.L., Tsai S.T. Bilateral carpal tunnel syndrome secondary to tophaceous compression of the median nerves. Scandinavian Journal of Rheumatology.1996;25(2):107-108. doi: 10.3109/03009749609069218.Tsai C.Y., Yu C.L., Tsai S.T. Bilateral carpal tunnel syndrome secondary to tophaceous compression of the median nerves. Scandinavian Journal of Rheumatology.1996;25(2):107-108. doi: 10.3109/03009749609069218.Chen C.K.H., Chung C.B., Yeh L.R. et al. Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients.American Journal of Roentgenolo gy.2000;175(3):655-659. doi: 10.2214/ajr.175.3.1750655.Chen C.K.H., Chung C.B., Yeh L.R. et al. Carpal tunnel syndrome caused by tophaceous gout: CT and MR imaging features in 20 patients.American Journal of Roentgenolo gy.2000;175(3):655-659. doi: 10.2214/ajr.175.3.1750655.Pai C.H., Tseng C.H. ACUTE CARPAL-TUNNEL SYNDROME CAUSED BY TOPHACEOUS GOUT.Journal of Hand Surgery-American Volume.1993;18A(4):667-669.Pai C.H., Tseng C.H. ACUTE CARPAL-TUNNEL SYNDROME CAUSED BY TOPHACEOUS GOUT.Journal of Hand Surgery-American Volume.1993;18A(4):667-669.Luo P.B., Zhang C.Q. Chronic carpal tunnel syndrome caused by covert tophaceous gout: A case report.World Journal of Clinical Cases.2018;6(9):279-283. doi: 10.12998/wjcc.v6.i9.279Luo P.B., Zhang C.Q. Chronic carpal tunnel syndrome caused by covert tophaceous gout: A case report.World Journal of Clinical Cases.2018;6(9):279-283. doi: 10.12998/wjcc.v6.i9.279Lin Y.C., Chen C.H., Fu Y.C. et al. Carpal Tunnel Syndrome and Finger Movement Dysfunction Caused By Tophaceous Gout: A Case Report. Kaohsiung Journal of Medical Sciences.2009;25(1):34-39. doi: 10.1016/S1607-551X(09)70038-5.Lin Y.C., Chen C.H., Fu Y.C. et al. Carpal Tunnel Syndrome and Finger Movement Dysfunction Caused By Tophaceous Gout: A Case Report. Kaohsiung Journal of Medical Sciences.2009;25(1):34-39. doi: 10.1016/S1607-551X(09)70038-5.Electronic resource. URL: https://pubmed.ncbi.nlm.nih.gov/ (date of the application: 05.01.2021)Electronic resource. URL: https://pubmed.ncbi.nlm.nih.gov/ (date of the application: 05.01.2021)

The authors declare that there are no conflicts of interest present.