Hyperuricemia and gout are known to occur in patients receiving diuretic th
erapy More recently recognized, however is the occurrence of tophaceous gou
t in patients treated with cyclosporine. We report a 57-year-old man with n
ormal renal function who was started on cyclosporine immediately after unde
rgoing bilateral lung transplantation. Six months later he developed progre
ssive renal insufficiency and hypertension. In the following four months (1
0 months after starling his immunosuppressant medication), he presented wit
h a symmetrical distribution of tophi on his linger pads. Seven previous ca
ses of linger pad tophi have been reported and are reviewed.