Vol 9, No 3 (2023)
Review paper
Published online: 2023-09-29

open access

Page views 272
Article views/downloads 374
Get Citation

Connect on Social Media

Connect on Social Media

Pyrophosphate arthropathy — a literature review

Dorota Suszek1, Justyna Marcicka2, Joanna Męczyńska2, Michał Żuchowski2
Rheumatology Forum 2023;9(3):119-124.

Abstract

Joint diseases associated with calcium pyrophosphate crystals (calcium pyrophosphate dihydrate deposition disease, CPPD) are classified as crystallopathies. They clinically present as chondrocalcinosis, acute or chronic arthritis. The main risk factors are age, injuries and degenerative changes in the joints. One or more joints may be affected. Knees, wrists and shoulders are the most commonly affected joints. CPPD may be primary or secondary, and may be associated with hemochromatosis, hyperparathyroidism, hypothyroidism, and hypomagnesemia. Treatment is mainly symptomatic, most commonly using non-steroidal anti-inflammatory drugs, colchicine, or glucocorticoids.

Article available in PDF format

View PDF Download PDF file

References

  1. Calcium pyrophosphate Deposition Disease. Encyclopedia of Diagnostic Imaging. : 219–219.
  2. Fliciński J, Prajs K. Choroba związana z odkładaniem kryształów dwuwodnego pirofosforanu wapniowego. Przegląd Reumatologiczny. 2011; 5-6(39): 3–5.
  3. Stücker S, Bollmann M, Garbers C, et al. The role of calcium crystals and their effect on osteoarthritis pathogenesis. Best Pract Res Clin Rheumatol. 2021; 35(4): 101722.
  4. Abhishek A, Doherty M. Epidemiology of calcium pyrophosphate crystal arthritis and basic calcium phosphate crystal arthropathy. Rheum Dis Clin North Am. 2014; 40(2): 177–191.
  5. Williams CJ, Rosenthal AK. Pathogenesis of calcium pyrophosphate deposition disease. Best Pract Res Clin Rheumatol. 2021; 35(4): 101718.
  6. Rosenthal AK, Ryan LM. Calcium Pyrophosphate Deposition Disease. N Engl J Med. 2016; 374(26): 2575–2584.
  7. Iqbal SM, Qadir S, Aslam HM, et al. Updated Treatment for Calcium Pyrophosphate Deposition Disease: An Insight. Cureus. 2019; 11(1): e3840.
  8. Rosales-Alexander JL, Balsalobre Aznar J, Magro-Checa C. Calcium pyrophosphate crystal deposition disease: diagnosis and treatment. Open Access Rheumatol. 2014; 6: 39–47.
  9. Bencardino JT, Hassankhani A. Calcium pyrophosphate dihydrate crystal deposition disease. Semin Musculoskelet Radiol. 2003; 7(3): 175–185.
  10. Tausche AK, Aringer M. [Chondrocalcinosis due to calcium pyrophosphate deposition (CPPD). From incidental radiographic findings to CPPD crystal arthritis]. Z Rheumatol. 2014; 73(4): 349–57; quiz 358.
  11. Higgins PA. Gout and pseudogout. JAAPA. 2016; 29(3): 50–52.
  12. Ea HK, Lioté F. Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am. 2014; 40(2): 207–229.
  13. Ferrone C, Andracco R, Cimmino MA. Calcium pyrophosphate deposition disease: clinical manifestations. Reumatismo. 2012; 63(4): 246–252.
  14. Zimmermann-Górska I. Choroby wywołane przez kryształy pirofosforanu wapnia. Medycyna Praktyczna, Interna — Mały Podręcznik. 2022.
  15. Duran Tİ, Özgen M. Two cases of calcium pyrophosphate deposition disease (CPPD) presented with spondylodiscitis. Eur J Rheumatol. 2020; 7(2): 84–87.
  16. Greca I, Ben Gabr J, Perl A, et al. Trauma Induced Calcium Pyrophosphate Deposition Disease of the Lumbar Spine. Case Rep Rheumatol. 2020; 2020: 3218350.
  17. Tausche AK, Reuss-Borst M. [Crystal arthropathies]. Dtsch Med Wochenschr. 2019; 144(15): 1055–1060.
  18. Filippou G, Filippucci E, Mandl P, et al. A critical review of the available evidence on the diagnosis and clinical features of CPPD: do we really need imaging? Clin Rheumatol. 2021; 40(7): 2581–2592.
  19. Sirotti S, Gutierrez M, Pineda C, et al. Accuracy of synovial fluid analysis compared to histology for the identification of calcium pyrophosphate crystals: an ancillary study of the OMERACT US Working Group - CPPD subgroup. Reumatismo. 2021; 73(2): 106–110.
  20. Zamudio-Cuevas Y, Martínez-Nava GA, Martínez-Flores K, et al. Synovial fluid analysis for the enhanced clinical diagnosis of crystal arthropathies in a tertiary care institution. Clin Rheumatol. 2021; 40(8): 3239–3246.
  21. Lehmann B, Betsch-Bischof B, Horn R. [Arthrocentesis in the Emergency Department]. Ther Umsch. 2020; 77(5): 213–217.
  22. Kaneyama H, Morishita Y, Kawano O, et al. Acute Attack of Pseudogout with the Wide Lesion in Lumbar Spondylolytic Spondylolisthesis. Case Rep Orthop. 2020; 2020: 4512695.
  23. Zell M, Aung T, Kaldas M, et al. Calcium pyrophosphate crystal size and characteristics. Osteoarthr Cartil Open. 2021; 3(1).
  24. Jacques T, Michelin P, Badr S, et al. Conventional Radiology in Crystal Arthritis: Gout, Calcium Pyrophosphate Deposition, and Basic Calcium Phosphate Crystals. Radiol Clin North Am. 2017; 55(5): 967–984.
  25. Filippou G, Scanu A, Adinolfi A, et al. Criterion validity of ultrasound in the identification of calcium pyrophosphate crystal deposits at the knee: an OMERACT ultrasound study. Ann Rheum Dis. 2021; 80(2): 261–267.
  26. Cai K, Tedeschi SK. Review: Outcome measures in calcium pyrophosphate deposition. Best Pract Res Clin Rheumatol. 2021; 35(4): 101724.
  27. Ziegeler K, Diekhoff T, Hermann S, et al. Low-dose computed tomography as diagnostic tool in calcium pyrophosphate deposition disease arthropathy: focus on ligamentous calcifications of the wrist. Clin Exp Rheumatol. 2019; 37(5): 826–833.
  28. Nowak P. [Hemochromatosis related Arthropathy]. Ther Umsch. 2018; 75(4): 235–239.
  29. Tedeschi SK, Becce F, Pascart T, et al. Imaging Features of Calcium Pyrophosphate Deposition Disease: Consensus Definitions From an International Multidisciplinary Working Group. Arthritis Care Res (Hoboken). 2023; 75(4): 825–834.
  30. Cadiou S, Le Gruyer A, Giguet B, et al. Calcium pyrophosphate deposition (CPPD) in a liver transplant patient: are hypomagnesemia, tacrolimus or both guilty? A case-based literature review. Rheumatol Int. 2022; 42(6): 1105–1112.
  31. Catelli A, Venetucci P, Castaldo A, et al. Calcium pyrophosphate deposition disease: The role of imaging in their detection and in differential diagnosis of crystal arthropathies. Radiol Case Rep. 2020; 15(10): 1773–1776.
  32. Cipolletta E, Di Matteo A, Filippucci E, et al. Calcium Pyrophosphate Deposition Disease in a Patient with Familial Hypokalemia-Hypomagnesemia (Gitelman's-Syndrome): A Case Report - CPPD in Gitelman's syndrome. Ultraschall Med. 2020; 41(6): 695–697.
  33. Stack J, McCarthy G. Calcium pyrophosphate deposition (CPPD) disease - Treatment options. Best Pract Res Clin Rheumatol. 2021; 35(4): 101720.
  34. Sidari A, Hill E. Diagnosis and Treatment of Gout and Pseudogout for Everyday Practice. Prim Care. 2018; 45(2): 213–236.
  35. Rigsbee CA, Sizemore TC, Lohr KM. Severe calcium pyrophosphate dihydrate deposition disease of the metacarpophalangeal joints. BMJ Case Rep. 2018; 2018.
  36. Sivera F, Andrés M, Pascual E. Current advances in therapies for calcium pyrophosphate crystal arthritis. Curr Opin Rheumatol. 2016; 28(2): 140–144.
  37. Altomare A, Corrado A, Maruotti N, et al. The role of Interleukin-1 receptor antagonist as a treatment option in calcium pyrophosphate crystal deposition disease. Mol Biol Rep. 2021; 48(5): 4789–4796.
  38. Andrés M, Sivera F, Pascual E. Therapy for CPPD: Options and Evidence. Curr Rheumatol Rep. 2018; 20(6): 31.
  39. Parperis K, Papachristodoulou E, Kakoullis L, et al. Management of calcium pyrophosphate crystal deposition disease: A systematic review. Semin Arthritis Rheum. 2021; 51(1): 84–94.
  40. Cipolletta E, Di Matteo A, Scanu A, et al. Biologics in the treatment of calcium pyrophosphate deposition disease: a systematic literature review. Clin Exp Rheumatol. 2020; 38(5): 1001–1007.
  41. Krekeler M, Baraliakos X, Tsiami S, et al. High prevalence of chondrocalcinosis and frequent comorbidity with calcium pyrophosphate deposition disease in patients with seronegative rheumatoid arthritis. RMD Open. 2022; 8(2).
  42. Shen G, Su M, Liu B, et al. A Case of Tophaceous Pseudogout on 18F-FDG PET/CT Imaging. Clin Nucl Med. 2019; 44(2): e98–e9e100.