Tophaceous Gout Misidentified as Inflammatory Polyp in External Auditory Canal

Gout is an inflammatory disorder in which urate crystals are deposited in the joints or soft tissues causing severe inflammation and pain. Urate crystals usually deposit in the joints, and sometimes in the extra-articular sites. A 67-year-old woman visited the otolaryngology clinic due to otalgia and discharge from the ear. She had experienced recurrent arthritis in the left second metatarsophalangeal joint from five years ago. She visited the otolaryngology clinic of our university hospital due to persistent inflammation in the ear canal despite treatment with antibiotics. An otoscopic examination showed a polyp-like mass near the eardrum. Computed tomography scan of temporal bone showed thickening of the eardrum and increased soft tissue density in the external ear canal. On histologic examination the polyp was finally found to be a urate crystal mass. She is now in a good state with urate lowering therapy. We report on a Korean case of tophaceous gout in the external ear canal that was misidentified as an inflammatory polyp.

Two cases of obesity-related glomerulopathy / 대한내과학회지

Obesity or being overweight may be associated with various functional and structural lesions of the kidneys. It is common in patients with diabetes having a high body mass index (BMI), but it also occurs in patients with increased proteinuria. Recently, we treated a 28-year-old woman and a 15-year-old boy with proteinuria and a high BMI (woman: 35 kg/m2; boy: 27.7 kg/m2). At that time, they were diagnosed with obesity-related glomerulopathy based on the laboratory, urinary, and kidney biopsy findings. After treatment with an angiotensin-converting enzyme inhibitor and weight loss, the proteinuria was sustained in the latter, while it improved in the former. We believe that these cases suggest an association between obesity and glomerulopathy

A Case of Constrictive Pericarditis Associated With Huge Epicardial Fat Volume

Massive deposits of fat around heart are seen in overweight persons and are associated with coronary artery disease. Investigators have focused on the clinical significance of epicardial fat with respect to metabolic effects such as insulin resistance and inflammation, but the mechanical effects, such as constriction, have been largely ignored. We present an unusual case of a 59-year-old woman with obesity and diabetes mellitus who had been undergoing peritoneal dialysis due to end-stage renal disease, and who developed constrictive pericarditis, possibly secondary to extensive epicardial fatty accumulation.