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Acute pseudogout in chronic renal failure.

M H Ellman, N L Brown, C A Katzenberg

Archives of Internal Medicine

|July 1, 1979

Summary

Pseudogout, or calcium pyrophosphate dihydrate deposition disease, can cause acute arthritis in patients with chronic renal failure. This condition may be more common than previously thought, especially in older dialysis patients.

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Area of Science:

Nephrology
Rheumatology
Crystal-induced arthritis

Background:

Chronic renal failure (CRF) is a complex condition affecting multiple organ systems.
Calcium pyrophosphate dihydrate deposition disease (CPPD disease), also known as pseudogout, is characterized by the deposition of CPPD crystals in joints.
The association between CRF and pseudogout is not well-established, with limited data on its prevalence and presentation in this population.

Observation:

Two patients with CRF developed acute pseudogout with atypical, diffuse joint calcifications.
One patient was unusually young (39 years old) for pseudogout onset.
Chondrocalcinosis was observed, with one patient presenting limited elbow involvement.

Findings:

A review of wrist roentgenograms in 82 hemodialysis patients revealed a 3.7% incidence of chondrocalcinosis.
The incidence of chondrocalcinosis increased significantly to 15.8% in patients over 60 years of age.
These findings suggest pseudogout may be an underrecognized cause of acute arthritis in CRF.

Implications:

Pseudogout should be considered in the differential diagnosis of acute arthritis in patients with chronic renal failure.
Early diagnosis through joint aspiration and crystal identification is crucial for appropriate management.
Further research is warranted to understand the pathophysiology and optimal treatment strategies for pseudogout in CRF patients.

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