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Results for “Calcium Pyrophosphate”

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PubMed1986

Crystallographic identification of a calcium deposit in calcified pericarditis associated with articular chondrocalcinosis.

In a case of CPPD crystal deposition disease of the pseudorheumatoid type and of long duration, calcified constrictive pericarditis developed and was surgically treated. Analysis of the calcium deposit in the pericardium was carefully made by infrared absorption, x-ray diffraction, and thermogravimetry. It revealed that the deposit was composed of B-type carbonated apatite. Previously, both calcium pyrophosphate dihydrate (CPPD) and apatite crystals, either in the same place or in different tissues, have been reported in the same patient. These observations raise the possibility that the same metabolic error might lead to both types of crystal deposition.

Apatites↗

PubMed2002

Bilateral temporomandibular joint pseudogout.

Pseudogout is an acute presentation of one type of crystal deposition disease in which calcium pyrophosphate dihydrate crystals are found in the joint spaces of synovial joints. In this case, a 56-year-old caucasian male presented with right sided preauricular swelling, temporomandibular joint arthralgia and restricted mouth opening; he developed identical symptoms on the left side two days later.

Arthralgia↗

PubMedDate not supplied

[Detection and identification of crystals in synovial fluid].

Synovial fluid analysis for crystals represents one of the most important laboratory test for the evaluation of rheumatic diseases. The identification of monosodium urate and calcium pyrophosphate dihydrate crystals allows the prompt diagnosis of gout and pyrophosphate crystal-related arthropaties. Crystals are identified based on their shape and birefringence through a polarized light microscope equipped with a first order red compensator. Due to its simple execution and high diagnostic value, this examine should be always performed to complete synovial fluid analysis.

Calcium Pyrophosphate↗

PubMed1993

Cystic change in the head of the fibula in osteoarthritis.

We report eight patients with prominent cystic changes in the head of the fibula. Seven of these had osteoarthritis of the adjacent knee, and five had evidence of local deposition of calcium pyrophosphate dihydrate crystals. A radiographic survey of 470 knees in 254 patients with osteoarthritis suggested that such cysts are rare, but should be considered in the differential diagnosis of such changes before expensive or invasive investigations are performed.

Aged↗

PubMed1979

[Pharmacologic study of inflammatory processes. Modification of polynuclear neutrophil chemotaxis].

A study of rat polymorphonuclear chemotaxis has been made by a direct microscopic method and the effect of inflammatory reactions induced by carrageenan, calcium pyrophosphate and complete Freund's adjuvant has been studied. In addition the action of various drugs such as cholera toxin, colchicine, prostaglandins and certain immunomodulators, was investigated. The results have been analysed with special regard to the role of chemotaxis in inflammatory responses.

Animals↗

PubMed1982

Articular cartilage in the degenerative arthropathy of hemochromatosis.

Iron was readily demonstrated in chondrocytes in 3 of 4 hemochromatosis articular cartilages studied. Either apatite, calcium pyrophosphate dihydrate crystals, or both were found in all cartilages including those of 3 patients who had no radiographic or light microscopic evidence of calcification. These crystals, which may be secondary to degenerative changes or may play a role in cartilage degeneration, were not seen in any consistent morphologic relationship with the iron deposits. In fact, apatite was found in one cartilage in which no iron was identified in the sections studied. If iron, as demonstrated in the chondrocytes, is contributing to the calcium crystal deposition, it would most likely do so indirectly, for example by altering chondrocyte enzymes or connective tissue components.

Aged↗

PubMed2000

A case of pseudogout.

We report a 56-year-old Japanese male with a gout-like acute attack of synovitis and panniculitis in his right wrist without hyperuricemia. Calcium pyrophosphate dihydrate (CPPD) crystals were found in the synovial fluid of the affected joint. A diagnosis of pseudogout was made. The attack subsided two days after medication with 30 mg of predonisolon. Although this is a relatively common disease in elderly people, we rarely encounter such case reports in dermatological journals.

Calcium Pyrophosphate↗

PubMed1980

[A fortultousness association: Bartter's syndrome and chondrocalcinosis (author's transl)].

Two adults patients presenting Bartter's syndrome have been studied for 9 years in one case, 7 years in the other. Both were affected with chondrocalcinosis. This association does not seem to be coincididental but suggests a pathogenic link between Bartter's syndrome and chondrocalcinosis; the two patients presented hypomagnesemia which, inhibiting intrasynovial pyrophosphatase, induces calcium pyrophosphate crystals deposits on fibrocartilages. Otherwise, excessive daily urinary excretion of PG E2 and PG F2 alpha was found in both patients. Indomethacin (150 mg daily) decreased urinary excretion of PG to normal values in the two cases, Kalaemia was completely normalized in one case, partially in the other.

Adult↗

PubMed1990

Cervical myelopathy in C.P.P.D. deposition disease.

Cervical Myelopathy is a rare manifestation of calcium pyrophosphate dihydrate (C.P.P.D.) deposition disease. A case is presented where radiographically noncalcified extradural masses containing C.P.P.D. crystals were present at the C7 level, producing cord compression and neurological symptoms. These masses are thought to represent para-articular deposits related to the adjacent facet joints.

Aged↗

PubMed1993

[Alizarin red S staining of calcium compound crystals in synovial fluid].

In order to study the clinical value of alizarin red S staining of calcium compound crystals in synovial fluid, the optimum conditions for staining and the detectable threshold of the crystals were examined. The staining of crystals was mainly affected by the concentration of the dye and pH of the solution. The best results were obtained with an alizarin red S concentration of 1.5-3.0% for hydroxyapatite (HA) and 2.0-3.0% for calcium pyrophosphate dihydrate (CPPD) crystal. The optimal pH of the solution was 4.0-6.0 for HA and 4.0-5.5 for CPPD crystal. For the detection of crystals phagocytosed by synovial fluid leukocytes, staining was enhanced by the addition of chloral hydrate to the dye solution which increased the permeability of the cell membrane. The detectable threshold levels of HA and CPPD crystal in synovial fluid by alizarin red S staining were 0.1 micrograms/ml and 0.5 micrograms/ml, respectively. These results suggest that alizarin red S staining is suitable for screening calcium compound crystals in synovial fluid, because it is more sensitive than other methods, such as polarized microscopy and X-ray diffraction. Alizarin red S staining was performed on 148 synovial fluids from patients with various joint diseases. The staining was positive in 100% of synovial fluids from patients with CPPD deposition disease, in 54% of fluids with osteoarthritis, and in 39% of fluids with rheumatoid arthritis. In osteoarthritis, the increase in the proportion of positive cases was found to be in accordance with the radiological grading of the joints.

Anthraquinones↗

PubMed1992

Nail-patella syndrome associated with mixed crystal deposition arthropathy.

This report describes a case of nail-patella syndrome in a woman with a strong family history who presented with effusions in her shoulder and knees. Microscopic examination of the shoulder fluid suggested the presence of calcium pyrophosphate dihydrate (CPPD) crystals, and examination of the knee fluid suggested both hydroxyapatite (HAP) and CPPD crystals. To our knowledge, the coexistence of these two conditions has not been reported in the past. Moreover, it brings up a new element regarding the inflammatory origin of the nail-patella syndrome.

Arthritis↗

PubMed1997

[Calcification of cervical ligamentum flavum--analysis of calcium compounds and histopathological findings].

We operated 3 patients with cervical myelopathy due to calcification of ligamentum flavum (CLF). Specimens collected surgically were subjected to X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and Raman spectroscopy (Raman) analysis and also histopathological examination. The calcium compounds deposited were calcium pyrophosphate dihydrate (CPPD) in Case 1, apatite in Case 2, and a double-layer structure with an outer CPPD layer and an inner carbonate apatite layer in Case 3. Histopathologically, CPPD deposition in Case 1 could be distinguished from apatite deposition in Case 2 and 3 by hematoxylin-eosin stain. Chondrocytes were observed in all 3 cases, suggesting the chondrocytes may have played a role in calcification in these three cases. To date, 62 cases of CLF (including the present cases) have been reported, and analysis of calcium compound has been performed for 29 of them. Of these 29, 15 were analyzed as calcium phosphate compounds, 9 as CPPD and 4 cases as mixed crystals like Case 3. However the analysis method and result about CPPD are no problem, the analysis result of calcium phosphate compounds depends on the using methods. Calcium phosphate or undetectable compounds was identified by XRD as hydroxyapatite (HAp), and by FTIR as calcium phosphate or undetectable compound. Analysis of calcium phosphate compounds should be condacted and identified by XRD, FTIR, and Raman. We propose two possible mechanisms for the formation of the double-layer structure in Case 3: one is formation of apatite first followed by deposition of CPPD outside, and the other is formation of CPPD first followed by conversion of CPPD in the central region to apatite. What the process of formation of the double-layer was in this cases remains unclear.

Aged↗

PubMed1993

Superoxide anion production and phagocytosis of crystals by cultured endothelial cells.

OBJECTIVE: To show that cultured human umbilical vein endothelial cells (HUVEC) are capable of phagocytizing inflammation-causing crystals and of generating superoxide anion (SOA) during phagocytosis. METHODS: The superoxide dismutase-inhibitable reduction of nitroblue tetrazolium (NBT) dye was used as a measure of SOA production. Phagocytosis was quantified by light microscopy and confirmed by transmission electron microscopy. Cytochrome C was also studied but was found to undergo spontaneous reduction by monosodium urate (MSU) without cells. RESULTS: Crystals of MSU, calcium oxalate, hydroxyapatite, and calcium pyrophosphate dihydrate (CPPD) were phagocytized and, except for the CPPD crystals, induced NBT reduction. Cholesterol and cholesterol monohydrate were neither phagocytized nor did they induce NBT reduction. CONCLUSIONS: Endothelial cells may be a significant source of oxygen radicals in crystal-associated and other arthritides.

Calcium Oxalate↗

PubMed1999

Calcifications of the disc of the temporomandibular joint.

Calcified lesions of the temporomandibular joint discs obtained from 135 human cadavers were studied. Calcifications were observed in 92 of 250 discs by soft x-ray radiography. Studies by light and electron microscopy and x-ray diffraction revealed that there were two different types of calcification in the discs: apatite crystal deposition with or without ossification, and calcium pyrophosphate dehydrate (CPPD) crystal deposition. Calcifications were recognized more frequently posteriorly than anteriorly, and were related to disc perforation. The results of this investigation suggest that disc degeneration, which may occur as a result of aging or mechanical stress, causes calcifications.

Aged↗

PubMed1977

Tendon calcifications in chondrocalcinosis. A clinical, radiologic, histologic, and crystallographic study.

Fine linear extraarticular calcium deposits were found in X-rays of 7 of 52 patients with articular chondrocalcinosis (ACC). Seven Achilles tendons, seven quadriceps tendons, and one plantar fascia were affected. In a control group of comparable age and sex, without ACC but with generalized osteoarthritis, no calcifications were found in the tendons. On a biopsy specimen of Achilles tendon with such calcium deposits, X-ray diffraction showed that they had the characteristics of calcium pyrophosphate dilhydrate. Isolated small foci of crystals were observed on some segments of tendon bundles. The presence of fine linear calcifications on X-rays of the Achilles or quadriceps tendons may be a useful aid in the radiologic diagnosis of so-called articular chondrocalcinosis.

Achilles Tendon↗

PubMed1978

Crystal induced arthritis: gout and pseudogout.

Intrasynovial deposits of monourate crystals in the presence of serum hyperuricaemia, and calcium pyrophosphate dihydrate (CPPD) crystals, are responsible for gout and pseudogout respectively. Identification of these by synovial fluid analysis is described. The clinical features, minimum investigations, history-taking, management and drug regimes of gout and pseudogout are discussed. Periodic review of the patient is stressed. Other intrasynovial crystals are briefly outlined.

Acute Disease↗

PubMed1997

The priming action of tumour necrosis factor-alpha (TNF-alpha) and granulocyte-macrophage colony-stimulating factor (GM-CSF) on neutrophils activated by inflammatory microcrystals.

We studied the effects of TNF-alpha or GM-CSF on the production of reactive oxygen species (as measured by chemiluminescence) and degranulation responses of neutrophils to opsonized inflammatory microcrystals. TNF-alpha in the 10-2000 pM or GM-CSF in the 2-200 pM concentration range caused the concentration-dependent amplification of neutrophil chemiluminescence responses to both calcium pyrophosphate dihydrate (CPPD) and monosodium urate monohydrate (MSUM) crystals. Degranulation responses, as measured by the extracellular release of the granule enzymes myeloperoxidase or lysozyme, were amplified by approximately 50-100% for both MSUM or CPPD crystal-induced neutrophil activation when cells were pretreated with TNF-alpha at 2000 pM or GM-CSF at 75 pM.

Calcium Pyrophosphate↗

PubMed1982

Crystal arthropathies in osteo-arthritis--clinical aspects and laboratory techniques for crystal identification.

Crystal arthropathies are frequent findings in patients with radiographical osteo-arthritis (OA). The associations between cartilage degeneration and crystal deposition of hydroxy-apatite or calcium pyrophosphate dihydrate are not yet understood. However, from the clinical point of view it is important to differentiate synovitis caused by micro-crystals from other symptoms in OA since symptomatic relief is readily obtained with the use of antiphlogistic drugs. Methods to screen synovial fluids for crystals should be introduced in routine clinical practice.

Aging↗