Abstract：A 56-year-old male patient underwent percutaneous coronary intervention (PCI) due to acute ST elevation myocardial infarction. He received a combination therapy with aspirin enteric coated tablets 100-mg orally once daily and ticagrelor 90-mg orally twice daily for antiplatelet aggregation after the PCI. The patient had a history of gout for more than 20 years. On the 24th day of medication, the patient developed fever and the symptoms of redness, swelling, heat, and pain in multiple joints. Laboratory tests showed white blood cell count 9.8×109/L, neutrophils 0.83, and blood uric acid 538-μmol/L. Ultrasonography of the joints showed swelling and thickening of some joint cysts, limited thickening of soft tissue, and scattered crystalline deposits on the articular cartilage. He was diagnosed as having gouty arthritis, which might be associated with ticagrelor. Ticagrelor was stopped. The patients were treated with dual antiplatelet therapy consisting of aspirin 100-mg orally once daily and clopidogrel 75-mg orally once daily. At the same time, the treatments of diet control, strengthening exercise, and urate lowering drugs were given. Ten days later, the result of reexamination showed that serum uric acid was 287-μmol/L. Therefore, dual antiplatelet therapy with aspirin and ticagrelor was resumed, and no further gouty arthritis attacks occurred.
