Severe gouty arthritis refractory to anti-inflammatory drugs: treatment with anti-tumour necrosis factor α as a new therapeutic option

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Abstract
At the first consultation the patient had severe painful gouty arthritis (three to four attacks a week) of the joints of the big toes, the ankle joints, and different finger joints as well as in joints of the hands, shoulders, and knees. In addition to the polyarticular joint manifestation, multiple gouty tophi were present in the subcutaneous tissue (fig 1 ⇓ ).