Death of captive-bred vultures caused by flunixin poisoning in Italy

Among non steroidal anti-inflammatory drugs (NSAIDs) diclofenac is considered the main cause for the decline of vulture populations in the Indian subcontinent since the '90 s. Chemical analysis showed high levels of flunixin (31,350 μg/kg) in beef which three captive Gyps vultures fed on, later dying with severe visceral gout. Levels in dead vultures' organs and tissues ranged from 4 to 38.5 μg/kg. The typical lesions and the concentrations found in beef indicate flunixin as the cause of death. This is the first observational study which correlates the concentration of flunixin in the meat ingested with that found in tissues of vultures.

Unusual presentation of gouty tophus in the liver with subsequent appearance in the same site of HCC: a correlate diagnosis? Case report

Background

Although gout is a common disease, the presence of gouty tophi outside joints is rare and in literature, there is to date only one report of hepatic tophaceous nodule. We would like to highlight here the difficult diagnostic workup in a patient with history of cancer and the presence of a tophus inside the liver. Moreover, we address the possible etiologic role of chronic inflammation related to tophi and liver cancer.

Case presentation

We present the case of a 72-year-old man with a localization of gouty tophus in the liver, who thereafter developed a hepatocellular carcinoma (HCC) in the same site. The patient was followed up after surgery for left renal cancer from 1992 to 2011, when a hepatic nodule was discovered for the first time. After a detailed evaluation, the nodule was classified as a urate tophus of the liver. However, further follow-up showed that the nodule increased in size and changed its characteristics, bringing to the diagnosis of HCC.

Conclusions

With the present case report, we would discuss the possible neoplastic degeneration of a gouty tophus and its etiologic role favouring cellular degeneration linked to chronic inflammation. We would also highlight the importance of histopathological evaluation of hepatic lesions in gouty patients at high risk of liver neoplasm, due to the difficulty in characterizing gouty tophi by imaging.

Visceral urate deposition in a little bittern (Ixobrychus minutus)

Visceral urate deposition (visceral gout) is a common finding during post-mortem examination of poultry. Rare cases of visceral gout may occur in wild birds. A rare case of visceral urate deposition in a little bittern (Ixobrychus minutus) is reported here. In May 2013, carcass of a little bittern was submitted for necropsy to the Clinic of Poultry Diseases (Faculty of Veterinary Medicine, Razi University) by local authorities of Iran Department of Environment. At necropsy, white chalky deposits were observed on the heart and thoracic air sacs of the bird. To confirm the presence of urates, chalky deposits were collected from pericardium and tested by muerxide test. Heart and kidneys were sampled, preserved in 10% neutral-buffered formalin solution and submitted to laboratory for histopathology. Murexide test was positive for presence of uric acid in chalky deposits collected from pericardium. Light microscopy of affected organs confirmed the condition as visceral urate deposition. To the best of our knowledge, this is the first report on the occurrence of visceral urate deposition in a little bittern.