XML Print


Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:

Lois S, Veeruswamy A, Kulandaivelu K, Muthusamy M P, Tun Oo Y. Secondary osteoarthritis due to alkaptonuria: a case report. Journal of Research in Applied and Basic Medical Sciences 2025; 11 (1) :68-74
URL: http://ijrabms.umsu.ac.ir/article-1-352-en.html
Department of Biochemistry, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India , drsabina81@gmail.com
Abstract:   (75 Views)
Background & Aims: Alkaptonuria is a rare autosomal recessive genetic disorder caused by a deficiency of homogentisate 1,2-dioxygenase, leading to the accumulation of homogentisic acid. It presents with a characteristic triad of homogentisic aciduria, ochronosis, and progressive arthritis, often resulting in secondary osteoarthritis, particularly affecting the hip and knee joints.
Case Description: A 58-year-old male presented with severe pain in the right hip and left shoulder. Since childhood, his urine had turned black upon exposure to sunlight. His medical history included multiple fractures and orthopedic interventions. On clinical examination, bluish-black discoloration of the ear lobes and sclera was noted. Biochemical testing, including Benedict’s test, ammoniacal silver nitrate test, and a filter paper spot test using 10% sodium hydroxide, confirmed the diagnosis of alkaptonuria. The patient was diagnosed with osteoarthritis secondary to alkaptonuria and underwent a successful total hip replacement.
Conclusion: Early diagnosis and intervention in alkaptonuria are crucial to preventing the debilitating effects of secondary osteoarthritis. A multidisciplinary approach in the management of patients with alkaptonuria can help reduce morbidity and improve quality of life by addressing both symptoms and the underlying disease.
Full-Text [PDF 940 kb]   (84 Downloads)    
Type of Study: case report | Subject: General

References
1. Wells C, Maxwell BM. Alkaptonuria in an Egyptian mummy. Br J Radiol 1962;35(418):679-82. [DOI:10.1259/0007-1285-35-418-679] [PMID]
2. Garrod AE. The incidence of alkaptonuria: a study in chemical individuality. Lancet 1902;160(4133):1616-20. [DOI:10.1016/S0140-6736(01)41972-6]
3. Garrod AE. Inborn errors of metabolism. Oxford: Oxford University Press; 1908. [Google books]
4. Pollak MR, Wu Chou YH, Cerda JJ, Steinmann B, La Du BN, Seidman JG, et al. Homozygosity mapping of the gene for alkaptonuria to chromosome 3q2. Nat Genet 1993;5(2):201-4. https://www.nature.com/articles/ng1093-201 [DOI:10.1038/ng1093-201] [PMID]
5. Bateson W. Mendel's principles of heredity. Cambridge: Cambridge University Press; 1909. [DOI:10.5962/bhl.title.44575] [PMID] [PMCID]
6. Schutgens RB. Review of: The metabolic and molecular bases of inherited disease. New York: McGraw-Hill; 1995.
7. Introne WJ, Perry M, Chen M. Alkaptonuria. University of Washington, Seattle, Seattle (WA); 1993. https://europepmc.org/books/nbk1454/ [PMID]
8. Mannoni A, Selvi E, Lorenzini S, Giorgi M, Airó P, Cammelli D, et al. Alkaptonuria, ochronosis, and ochronotic arthropathy. Semin. Arthritis Rheum 2004;33(4):239-48. https://www.sciencedirect.com/science/article/pii/S0049017203000805 [DOI:10.1053/S0049-0172(03)00080-5] [PMID]
9. Hugar SB, Shulman J, Yanta J, Nine J. Ochronosis presenting as methemoglobinemia. J. Forensic Sci 2019;64(3):913-6. https://onlinelibrary.wiley.com/doi/abs/10.1111/1556-4029.13907 [DOI:10.1111/1556-4029.13907] [PMID]
10. Avadhanula S, Introne WJ, Auh S, Soldin SJ, Stolze B, Regier D, et al. Assessment of thyroid function in patients with alkaptonuria. JAMA Netw. Open 2020;3(3):e201357. [DOI:10.1001/jamanetworkopen.2020.1357] [PMID] [PMCID]
11. Davison AS, Hughes AT, Milan AM, Sireau N, Gallagher JA, Ranganath LR. Alkaptonuria-Many questions answered, further challenges beckon. Ann Clin Biochem 2020;57(2):106-20. https://journals.sagepub.com/doi/abs/10.1177/0004563219879957 [DOI:10.1177/0004563219879957] [PMID]
12. Olsson B, Ranganath L, Arnoux J-B, Imrich R, Milan A, Rudebeck M. Effects of a protein-restricted diet on body weight and serum tyrosine concentrations in patients with alkaptonuria. JIMD Rep 2022;63(1):41 https://onlinelibrary.wiley.com/doi/abs/10.1002/jmd2.12255 [DOI:10.1002/jmd2.12255] [PMID] [PMCID]

Add your comments about this article : Your username or Email:
CAPTCHA

Send email to the article author


Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

© 2025 CC BY-NC 4.0 | Journal of Research in Applied and Basic Medical Sciences

Designed & Developed by : Yektaweb