[Arthropathy in idiopathic hemochromatosis]

In 22 of 35 patients (63%) with idiopathic hemochromatosis arthropathy could be demonstrated. In 20 patients the metacarpophalangeal joints (mainly II and III) with preference of the right hand were affected. Chondrocalcinosis of the wrist and knee was found both in two patients with metacarpophalangeal joint disease and in two patients without metacarpophalangeal disease. Further joints affected were the wrists (14), the other finger joints (11), and the knees (6). The dominant clinical complaint was pain in motion. Swelling and redness were rare findings only in case of acute exacerbations. The radiologic changes in the metacarpophalangeal joints were narrowing of the joint spaces, subchondral cysts, sclerosis of subchondral bone of metacarpal heads, and marginal osteophytic appositions at the joints. In one third of the patients arthropathy was evident before the diagnosis of idiopathic hemochromatosis was made. Histocompatibility testing confirmed that HLA-A3 is significantly more frequent in patients with idiopathic hemochromatosis than in normal persons. A statistically significant difference concerning HLA-phenotypes between patients with arthropathy and patients without arthropathy could not be detected. There was no case of arthropathy when 98 relatives of the patients were examined. However, idiopathic hemochromatosis was first detected in ten persons of this group.