Chronic tophaceous gout presenting with severe hypercalcemia - A rare clinical entity

Gout is an inflammatory arthritis caused by the accumulation of monosodium urate crystals within the synovial fluid and surrounding tissues. This condition is closely linked to hyperuricaemia, a serum urate concentration of 6.8 mg/dL or higher. If hyperuricaemia is not properly managed, the disease may progress to chronic tophaceous gout, which involves long-term joint damage and deposition of crystal aggregates (tophi) in joints and soft tissues. In this case report, we describe the case of a 62-year-old male who presented with altered mental status, generalised weakness, poor oral intake and diffuse body pain. Laboratory tests revealed severe hypercalcaemia, which is a rare presentation. The patient was treated with intravenous saline hydration, calcitonin and prednisone, which improved kidney function and normalised calcium levels.