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Case Reports in Medicine
Volume 2012 (2012), Article ID 657694, 4 pages
Case Report

Refractory Gout Attack

Rheumatology Division, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo (USP), Avenida Doutor Arnaldo 455, 01246-903 São Paulo, SP, Brazil

Received 11 August 2012; Revised 26 October 2012; Accepted 29 October 2012

Academic Editor: J. W. M. Van der Meer

Copyright © 2012 Simone Fargetti et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Refractory gout attack is an uncommon problem, since gout flares are usually self-limited. This clinical condition is characterized by serum uric acid higher than 6 mg/Dl or continuous manifestations of recurrent flares, chronic arthritis, and increased tophi. We report in this paper a 69-year-old man with a polyarticular and protracted gout attack, despite usual treatment and low urate sera levels. In order to manage this problem, we reviewed gout pathophysiology and developed a therapeutic solution based on benzbromarone pharmacokinetics. We also review herein new options for gout treatment that could be used in similar cases.