Calcium pyrophosphate crystal size and characteristics

Zell, Monica; Aung, Thanda; Kaldas, Marian; Rosenthal, Ann K.; Bai, Bijie; Liu, Tairan; Ozcan, Aydogan; FitzGerald, John

doi:10.1016/j.ocarto.2020.100133

Cited by 7 publications

(6 citation statements)

References 23 publications

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“…Traditionally, polarized light microscopy shows positively birefringent rhomboid (parallelepipedal form) crystals. However, in practice, it appears that CPPD crystals can often be smaller, weakly birefringent, and of variable shape from rod to cuboid, making synovial fluid analysis confirmation challenging [ [6] , [7] ]. Additionally, coexistence of monosodium urate crystals along with CPP crystals can further obscure diagnostic workup.…”

Section: Discussionmentioning

confidence: 99%

Pseudogout of the lumbar spine

Gupta¹,

Cherukuri²,

Chehab³

et al. 2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Pseudogout of the lumbar spine

Gupta¹,

Cherukuri²,

Chehab³

et al. 2023

Radiology Case Reports

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“…US aggregates can be seen in patients with CPPD. Similarly dense CPPD crystal aspirates are exceedingly rare and often small in size [15]. We did not look at clinical aspirates from patients with CPPD, and therefore cannot comment on potential similarities or differences.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound Findings of Monosodium Urate Aggregates in Patients with Gout

Liu

Dalbeth

Pool

et al. 2023

GUCDD

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Aggregates are one of the elementary lesions seen on musculoskeletal ultrasound (US) in gout patients as defined by Outcome Measures in Rheumatology (OMERACT). The aim of this study was to evaluate the threshold of detection of aggregate findings on ultrasound and to analyze these findings with corresponding compensated light microscope (CPLM) images in vitro. Patient derived monosodium urate (MSU) crystals were obtained from two separate patients with gout during routine clinical care. In addition, fabricated in-house synthetic MSU crystals were used for comparison. Each sample was scanned using a GE Logic ultrasound machine and corresponding CPLM images obtained. As the aggregates became imperceptible by ultrasound, MSU clumping by CPLM examination was no longer detectable and crystal density per high power field fell markedly. Aggregates on US images are present only from patient-derived samples likely representing MSU crystal clustering or packing. Thus, when synovial aspiration is considered, a joint with aggregates on US would be a more suitable target with a higher likelihood of noting MSU crystals.

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“…The diagnosis of CCs with polarized light microscopy may require training. The differential diagnosis using polarized light microscopy is calcium pyrophosphate (CPP) crystals 27) . The shapes of CPP crystals are rods or rhomboids.…”

Section: Advance Publication Journal Of Atherosclerosis and Thrombosismentioning

confidence: 99%

“…CPP crystals are almost always monolayered. Moreover, the length and width of CPP crystals are 3.7 and 1.0 μm, respectively 27) . CCs are parallelepiped shaped and are multilayered or monolayered.…”

Section: Advance Publication Journal Of Atherosclerosis and Thrombosismentioning

confidence: 99%

Cholesterol Crystals as the Main Trigger of Interleukin-6 Production through Innate Inflammatory Response in Human Spontaneously Ruptured Aortic Plaques

Komatsu¹,

Yutani

Takahashi³

et al. 2023

JAT

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Aim: This study aimed to clarify whether cholesterol crystals (CCs) are the main trigger of innate inflammation in human spontaneously ruptured aortic plaques (SRAPs). Methods: This study included 260 SRAPs collected during nonobstructive general angioscopy (NOGA) from 126 patients with confirmed or suspected coronary artery disease. Interleukin (IL)-6 levels in SRAPs were measured. IL-6 levels in the Valsalva sinus and femoral or brachial arteries were measured. IL-6 ratios (the IL-6 level in SRAPs and arteries divided by the IL-6 level at the Valsalva sinus at the beginning of the aorta) were calculated. Quantitative analysis of CCs was performed from SRAPs. The correlation between the count of CCs and IL-6 levels in SRAPs and that between the counts of CCs and IL-6 ratios in SRAPs were analyzed. Results: The IL-6 levels in SRAPs were 3.4 [2.1, 7.2] pg/mL, and the IL-6 ratio (median [interquartile range]) in SRAPs was 1.10 [1.00, 1.26]. CCs were detected in 94 of 260 SRAPs (36%). The count of CCs was 11,590 (95% confidence interval, 2,386-30,113) per 10 mL in CC-positive samples. There was a moderate correlation between the counts of CCs and IL-6 ratios in SRAPs (r=0.49, r＜0.0001), whereas there was no correlation between the count of CCs and IL-6 levels in SRAPs. The IL-6 ratios of the brachial and femoral arteries were 1.06 (95% CI, 0.99-1.20) and 1.11 (95% CI, 1.04-1.20), respectively. Conclusions: CC is the main trigger of IL-6 production through innate inflammatory response in human SRAPs in situ.

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Calcium pyrophosphate crystal size and characteristics

Cited by 7 publications

References 23 publications

Pseudogout of the lumbar spine

Pseudogout of the lumbar spine

Ultrasound Findings of Monosodium Urate Aggregates in Patients with Gout

Cholesterol Crystals as the Main Trigger of Interleukin-6 Production through Innate Inflammatory Response in Human Spontaneously Ruptured Aortic Plaques

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