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Calcium Pyrophosphate Dihydrate Disease

Dec 10, 2010 | By Ruth Coleman, M.D.

Calcium pyrophosphate dihydrate disease, or pseudogout, is a type of arthritis. The risk factors for developing this disease include having an injury to a joint, being older, having a disorder that deposits iron in the joints or being predisposed to developing calcium pyrophosphate dihydrate crystals in the joints. Medication can reduce the inflammation and pain caused by this disease.

Identification

Calcium pyrophosphate deposition disease is usually seen in people who are 60 or older, according to Dr. David Hellmann of John Hopkins University in "Current Medical Diagnosis & Treatment." It is also referred to as pseudogout because physicians first thought that people with this disorder had gout. Patients have a reoccurring arthritis that usually affects the wrists and knees but also might affect the hands, ankles, shoulders, hips and elbows.

Causes

Pain and inflammation associated with this disorder occur when calcium pyrophosphate dihydrate crystals are deposited in the affected joints. Approximately 70 percent of patients already have damaged joints, writes Dr. H. Ralph Schumacher of the University of Pennsylvania School of Medicine in "Harrison's Principles of Internal Medicine." Since most patients are also elderly, physicians hypothesize that the changes of aging along with the existing damage in the cartilage of their joints leads to this disease. A small number with pseudogout are younger than 50 years old and have high calcium levels, low alkaline phosphate and magnesium levels, or abnormal deposits of iron in various joints and organs.

Symptoms

People with pseudogout might suddenly have pain in a joint that can last for several days or as long as two weeks. The affected joint is usually warm, stiff, red and swollen. Once the pain stops, it does not usually return until the patient experiences another attack. Some may have pain in several joints, and those joints can feel stiff in the morning.

Diagnosis

A physician will take a sample of synovial fluid from the affected joint, a procedure referred to as fluid aspiration. Synovial fluid lubricates the synovium membrane that protects and surrounds the joint. If the disorder is calcium pyrophosphate dihydrate deposition disease, lab workers will see rhomboid- or rod-shaped crystals when they look at the sample under a microscope.

Treatment

Pseudogout symptoms decrease after a physician drains the synovial fluid that has accumulated in the joint and puts a corticosteroid such as prednisolone in the joint space. Prednisolone is a manufactured steroid hormone, similar to the corticosteroids that are naturally made by the adrenal gland, and it is used because it is anti-inflammatory. NSAIDs, or nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen also might help. Colchicine, an anti-inflammatory gout medication, might reduce the number of attacks.

References

Article reviewed by CH Last updated on: Dec 10, 2010

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