allopurinol and Nasal-Obstruction

Gout is a disease characterized by abnormal metabolism of the uric acid, leading to undesired buildup of monosodium urate crystals affecting mainly the first metatarsal-phalangeal joint of the foot and less commonly other joints or the soft tissues of the body. The prevalence of the disease increases with age, and it is statistically more observed in men than in women.We present the case of a 62-year-old male patient diagnosed as having gout 20 years ago. He came to the clinic with a nasal hump and a mass growing in his nose for the last 3 years, presenting as a nasal obstruction and facial deformity. Although the patient was treated with allopurinol and nonsteroidal anti-inflammatory drugs, surgical treatment was deemed necessary, and the patient was taken to receive a surgical resection of the nasal mass. The follow-up histopathology observation revealed deposits of urate crystals surrounded by a granulomatous inflammation. This confirmed the diagnosis-gouty tophi in the nose. In the follow-up period after the surgery, the patient reported overall improved breathing and aesthetic results.Tophi can be found in atypical locations, which increases morbidities and deformities caused by the disease. We report on this peculiar case of tophaceus gout as it is-a rare manifestation of the disease with tophi located in the nasal region.

Topics: Allopurinol; Biopsy, Needle; Gout; Humans; Immunohistochemistry; Male; Middle Aged; Nasal Cavity; Nasal Obstruction; Nose; Prognosis; Risk Assessment; Tomography, X-Ray Computed; Treatment Outcome; Uric Acid

Nitric oxide (NO) has been implicated in early and late phase nasal blockage in a Japanese cedar pollen-induced experimental allergic rhinitis guinea pig model. In this study, we investigated the role of peroxynitrite, which is formed by a rapid reaction of NO with superoxide anion, in the antigen-induced biphasic nasal blockage. Sensitized guinea pigs were repeatedly challenged by pollen inhalation once every week. The peroxynitrite scavenger, ebselen (30 mg/kg), or the xanthine oxidase inhibitor, allopurinol (50 mg/kg), was intraperitoneally administered 30 min before the antigen challenge. The late phase nasal blockage induced 4 h after the challenge was largely suppressed by ebselen (57% inhibition; P<0.05) and allopurinol (47% inhibition; P<0.05), but neither ebselen nor allopurinol influenced the early phase response. On the other hand, the intranasal instillation of peroxynitrite (10(-3) and 10(-2) M, 10 microl/nostril) caused a remarkable dose-dependent nasal blockage in the sensitized guinea pig. These results suggest that peroxynitrite plays a major role in the late phase nasal blockage induced by the antigen challenge in sensitized guinea pigs.

Topics: Administration, Intranasal; Allergens; Allopurinol; Analysis of Variance; Animals; Antioxidants; Azoles; Cryptomeria; Disease Models, Animal; Guinea Pigs; Isoindoles; Leukotriene D4; Male; Nasal Obstruction; NG-Nitroarginine Methyl Ester; Nitric Oxide Synthase; Organoselenium Compounds; Peroxynitrous Acid; Pollen; Rhinitis, Allergic, Seasonal; Xanthine Oxidase