Calcium pyrophosphate deposition (CPPD) disease – Treatment options

Stack, John; McCarthy, Géraldine

doi:10.1016/j.berh.2021.101720

Cited by 13 publications

(14 citation statements)

References 31 publications

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“…On the other hand, primary SC characterized by chondrocyte differentiation of synovial pluripotent stem cells, and chondroid tissue production of unknown cause may simply occur in tandem with a familial CPPD [10]. The present case had a possibility of DM comorbidity and class III malocclusion, A recent report by Stack and Geraldine [49] well summarized and discussed the treatment options for CPPD. There currently are no CPPD-modifying therapies that can reduce articular calcification.…”

Section: Discussionmentioning

confidence: 63%

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Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Murahashi

Ntege

Higa³

et al. 2022

BMC Oral Health

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Background The coexistence of calcium pyrophosphate dihydrate crystal deposition (CPP) and synovial chondromatosis (SC) in the temporomandibular joint (TMJ) is rarely reported. CPP disease (CPPD) is complex arthritis synonymous with excessive pyrophosphate production and variable aberrations in mineral and organic phase metabolism of the joint cartilage, leading to local inundated CPP and crystal deposition of partially deciphered predispositions. Meanwhile, SC is a rare benign synovial joint proliferative disease of unclear etiology and has a low risk of malignant transformation. However, SC manifests severe joint disability and dysfunction because of connective tissue metaplasia of the synovial membrane, which forms cartilaginous nodules with or without calcifications or ossifications. These nodules often detach and form intra-articular loose bodies and very rarely within extraarticular spaces. Case presentation We report the case of a 61-year-old man to expand the body of literature on these unusual coexisting arthropathies of the TMJ. The patient presented to our hospital in 2020 with complaints of pain in the right TMJ and trismus for over 6 months. Radiographic assessments of the TMJ provided a preoperative provisional diagnosis of SC. However, the histopathology of the open biopsy revealed tumor-like lesions comprising several deposits of rhomboid and rod-shaped crystals that displayed positive birefringence in polarized light, confirming a coexistence of CPPD. A second-stage operation was performed for the complete removal of the loose bodies and chalk-like lesions including synovectomy. No evidence of recurrence was recorded after a follow-up of nearly 1.5 years. Conclusions Isolated CPPD and SC of the TMJ are prevalent in the literature however, monoarticular coexistence of these diseases is rare, due to the lack of consistency in the diagnostic criteria in clinical practice. Moreover, optimal treatment depends on several considerations. This report delineated the molecular etiopathology and underscored the need for continued deciphering of the causal mechanisms of coexisting CPPD and SC of the TMJ. In addition, the importance of confirmatory testing for accurate diagnosis, and appropriate management of these diseases were discussed.

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Section: Discussionmentioning

confidence: 63%

“…A recent report by Stack and Geraldine [ 49 ] well summarized and discussed the treatment options for CPPD. There currently are no CPPD- modifying therapies that can reduce articular calcification.…”

Section: Discussionmentioning

confidence: 99%

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Murahashi

Ntege

Higa³

et al. 2022

BMC Oral Health

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“…18,19 Acute CPPD arthritis is usually well controlled by nonsteroidal antiinflammatory drugs, corticosteroids (oral or injectable), colchicine, and likely also anti-interleukin (IL)-1 and anti-IL-6 blockers, as has been reported in some patients. 20 Finally, there is a concern that joint lavage may favor the crystals shedding from the cartilage into the joint cavity, thus triggering an intense inflammatory reaction, as has already been reported. 21 Drs.…”

Section: Editorialmentioning

confidence: 91%

A New Look at an Old Procedure?

Richette

Latourte

2022

J Rheumatol

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“…It is interesting that although acute CPP arthritis is very common in clinical practice, studies on the use of colchicine for it have been very limited, and most of them used the intravenous route 16,17 ; with oral colchicine recommendations usually following gout treatment 18–20 …”

Section: Introductionmentioning

confidence: 99%

Non‐loading versus loading low‐dose colchicine in acute crystal‐associated arthritis: A double‐blinded randomized controlled study

Laosuksri,

Phrintrakul,

Gumtorntip

et al. 2023

Int J of Rheum Dis

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IntroductionThis study aimed to compare the efficacy of non‐loading versus loading low‐dose colchicine in patients with acute crystal‐associated arthritis.Materials and MethodsAll in‐patients who were admitted to Chiang Mai University Hospital with non‐arthritis disease and developed acute crystal‐associated arthritis during admission (within 48 h after arthritis onset) were invited to join this study. The patients were randomized into two groups. Patients in Group I (non‐loading group) and Group II (loading group) received colchicine at 1.2 and 2.4 mg in the first 24 h, respectively. The primary outcome was the patients' pain response at 24 h after treatment.ResultsOf 80 patients, 49 were acute gouty arthritis, and 31 acute calcium pyrophosphate (CPP) arthritis. The mean [95% CI] pain score was no different between Groups I and II at the baseline level (6.46[5.72–7.19] vs. 6.654[5.85–7.44], p = .867) and at 24 h (3.13[2.43–3.82] vs. 3.18[2.42–3.93], p = .907). The proportion of patients with ≥50% pain reduction was not different (57.50% vs. 55.00%, p = .822). Sensitivity analysis among patients with a baseline pain score of ≥4 showed the same pattern of response. Mild diarrhea was common and comparable in both groups. Subgroup analysis according to renal function (eGFR < 60 vs. ≥60 mL/min/1.73 m2) or type of crystals (acute gouty arthritis vs. acute CPP arthritis) also showed the same pattern of response.ConclusionNon‐loading low‐dose colchicine was as effective as loading low‐dose colchicine in patients with acute crystal‐associated arthritis, regardless of renal function or type of crystals.

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Calcium pyrophosphate deposition (CPPD) disease – Treatment options

Cited by 13 publications

References 31 publications

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

Management of temporomandibular joint diseases: a rare case report of coexisting calcium pyrophosphate crystal deposition and synovial chondromatosis

A New Look at an Old Procedure?

Non‐loading versus loading low‐dose colchicine in acute crystal‐associated arthritis: A double‐blinded randomized controlled study

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