[Acute gouty arthritis in adolescents with renal transplants]

Hyperuricemia is a common metabolic abnormality in subjects with renal transplantation: in fact in transplanted adults receiving immunosuppressive and diuretic drugs the frequency of hyperuricemia varied from 30 to 84% according to treatment. Conversely, the gout is an uncommon eventuality, representing less than 10%; predisposing factors are impaired renal function and older age. In the younger patients with renal transplantation hyperuricemia is also frequent, but the gout doesn't considered a possible complication in paediatric age. We reported our observation of 5 patients (3 males and 2 females), 13-18 years old who developed gout 2-84 months after renal transplantation. All the patients were receiving cyclosporine, 4 even with prednisone and azathioprine. Two patients were treated with furosemide because hypertension. The average of uric acid serum levels in the post transplantation follow-up was 7 +/- 2 mg/dl; at the moment of gout attack the uric acid serum levels raised to 12 +/- 1 mg/dl. The arthritis diagnosis were made by clinical, laboratory and instrumental data (Rx and US). In the most severe cases, uricasi therapy resolved clinical picture. The analysis of immunosuppressive and diuretic treatment, renal function and dietary uses induces us to think that the gout episode may be the result of many concomitant factors, in adolescents with renal transplant.