Alkaptonuria – a case for ethical assessment of pictorial anonymity

Abstract

I read with great interest the beautiful report of a patient with ochronosis from the Split KBC.1 The term "ochronosis" usually refers to a dark discoloration of connective tissue, mainly collagen, which shines through semipermeable media in a bluish-black color. It is a relatively rare condition, which, in addition to alkaptonuria, can occur with several systemic diseases (eg, osteogenesis imperfecta, Ehlers-Danlos syndrome or Addison's disease), and with some drugs (eg, amiodarone, minocycline, promazine). In the specific case of arthritic complaints along with the blueness of the ear and darkening of the urine, there were almost no differential diagnostic doubts.1 The therapeutic options for alkaptonuria are modest and approximately at the level of what I advised my first and only patient from central Bosnia, now far away in 1984: reduce body weight and, if necessary, take one of the non-steroidal antirheumatic drugs.