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[Pseudogout as a complication of stroke].
Takakuni Maki1, Michikazu Nakamura, Toshihiko Suenaga
1Department of Neurology, Tenri Hospital.
Rinsho Shinkeigaku = Clinical Neurology
|October 23, 2008
Summary
Pseudogout, a crystal-induced arthritis, frequently complicates stroke, particularly in older adults. Early recognition of pseudogout symptoms like fever is crucial for managing this post-stroke complication.
Area of Science:
- Rheumatology
- Neurology
- Internal Medicine
Context:
- Stroke is a leading cause of long-term disability.
- Pseudogout (calcium pyrophosphate deposition disease) is a common inflammatory arthritis.
- The relationship between stroke and pseudogout is not well-established.
Purpose:
- To investigate the incidence and clinical features of pseudogout developing after stroke.
- To characterize pseudogout in stroke patients, including affected joints, symptoms, and laboratory findings.
Summary:
- Ten of 181 stroke patients (5.5%) developed pseudogout, a significantly higher incidence than in other conditions.
- Onset occurred at a mean age of 82 years, typically within 5.5 days of stroke onset.
- Common symptoms included fever (90%) and elevated C-reactive protein (CRP) levels (mean 12.0 mg/dL).
- Affected joints were predominantly the knee, wrist, and atlantoaxial joint (crowned dens syndrome).
- Pseudogout occurred on the paretic side or in the atlantoaxial joint, often associated with immobility.
Impact:
- Highlights pseudogout as an underrecognized complication following stroke.
- Suggests increased vigilance for pseudogout in stroke patients, especially those with immobility.
- Informs clinical practice regarding the diagnosis and management of post-stroke pseudogout.
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