Treatment and management of pseudogout: insights for the clinician

Abstract

Clinical manifestations CPPD crystal deposition disease has the potential to mimic most forms of inflammatory arthritis and a clinical classification of these phenomena has emerged from the studies of McCarty and colleagues [McCarty, 1970, 1976; Rosenthal, 2001]. There are at least six distinct presentations of this disorder, and along with acute pseudogout include asymptomatic or lanthanic chondrocalcinosis, pseudo-OA (with or without acute attacks), pseudo-RA, pseudopolymyalgia rheumatica (pseudo-PMR) and pseudo-neuropathic arthropathy.

Comorbidities in Patients with Crystal Diseases and Hyperuricemia

“…3,193,194 Population studies using radiological evidence of chondrocalcinosis have estimated prevalence ranging between 7% and 10%, usually in population over 60 years, and have proven a positive association with age. 195–198 However, prevalence can vary depending on the method of identification.…”

Pseudogout-Associated Inflammatory Calcium Pyrophosphate Dihydrate Microcrystals Induce Formation of Neutrophil Extracellular Traps

“…The major focus of therapy is to control the inflammatory response and to prevent later relapses (4). Glucocorticoids, nonsteroid anti-inflammatory drugs, and colchicine are used to treat crystal-induced arthritis (6). These treatments are less effective in pseudogout than in gout and do not prevent or abolish inflammation entirely (4,6).…”

“…Glucocorticoids, nonsteroid anti-inflammatory drugs, and colchicine are used to treat crystal-induced arthritis (6). These treatments are less effective in pseudogout than in gout and do not prevent or abolish inflammation entirely (4,6). Further research is required to better understand details of the inflammatory process in pseudogout and to develop more efficient anti-inflammatory therapies.…”

“…Calcium-containing crystals directly interact with and activate synovial fibroblasts and chondrocytes (13,14). Recently, lots of attention was drawn to studies demonstrating inflammasome activation and IL-1b release in macrophages exposed to MSU or CPPD crystals (6,(15)(16)(17). These findings identified IL-1b as a central mediator and a novel therapeutic target of inflammation in crystal-induced joint diseases (18,19).…”

Calcium Pyrophosphate Dihydrate Deposition Disease in Young Patients: Two Case Reports

“…The characteristic crystals found in CPPD disease are generally rectangular, square, rhomboid or rod-shaped and can be seen using polarized light microscopy. 11,13 Linear or punctate calcification of the hyaline and fibrocartilage is the characteristic finding on plain X-ray in CC. 14 …”