We report the case of a 36-year-old man with psoriatic arthritis and miliary tuberculosis, whose serum uric acid (SUA) level increased after the initiation of antituberculosis treatment, which included pyrazinamide. Most strikingly and paradoxically, the patient's SUA level increased after treatment with allopurinol. On cessation of allopurinol, his SUA level decreased substantially, and complete normalisation was observed following the discontinuation of pyrazinamide treatment.
Adult ; Allopurinol ; therapeutic use ; Arthritis, Psoriatic ; drug therapy ; Humans ; Hyperuricemia ; chemically induced ; Male ; Pyrazinamide ; adverse effects ; Treatment Outcome ; Tuberculosis, Miliary ; drug therapy ; Uric Acid ; blood