Visceral gout

Figure 4.6 Proportion of vultures with diclofenac residues, visceral gout, or both (black area of each pie chart) at 13 locations where dead or dying vultures were found. The numbers next to each circle represent the number of birds assessed.

Oosporein, which is produced primarily by Oospora colo-rans and Caetomium trilaterale, is observed in feed stuffs, cereals and peanuts. It has been reported to be toxic in poultry resulting in nephrotoxicity, and visceral and articular gout. The pathological observations in oosporein toxicity include necrosis of the tubular epithelial cells in the proximal tubules with basophilic casts, hyaline casts in the distal tubules with fibrosis and interstitial pyogranuloma-tous inflammation, urate deposits in various tissues, and proventricular enlargement with mucosal necrosis (Pegram and Wyatt, 1981 Brown et al, 1987). 

Infection risk Serious infections in patients treated with anakinra for systemic juvenile idiopathic arthritis included one case each of an adenovirus infection, leading to chronic cough and clubbing, gastroenteritis with pre-renal failure, varicella pneumonitis, visceral leishmaniasis, and an acute Epstein-Barr virus infection [20 ]. A 32-year-old patient with severe juvenile-onset tophaceous gout developed HlNl influenza after taking anakinra [2T ]. 

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