Pseudogout: An Autoimmune Paraneoplastic Manifestation of Myelodysplastic Syndrome

Myelodysplastic syndrome (MDS) is often associated with autoimmune paraneoplastic manifestations. Seronegative arthritis is among one of them. Very rarely, pseudogout demonstrated as paraneoplastic autoimmune manifestations of MDS has been adumbrated so far. Our case would be the another addition in the series. Our patient is an 83-year-old male lately diagnosed with MDS. After six months of initial diagnosis, he had a sudden onset episode of pain and swelling involving left wrist. Synovial fluid analysis from respective radiocarpal joint confirmed the presence of intracellular positively birefringent rhomboid shaped crystals of calcium pyrophosphate dihydrate (CPPD). This was followed by another two flares of pseudogout involving right knee and lumbar spine at separate time intervals. Each of the episodes mentioned above responded well to intravenous and oral steroids. After the third bout, he was started treatment with azacitidine which showed effective abatement of further episodes of pseudogout up until now.