Clinical features in calcium pyrophosphate crystal deposition disease patients with hyperuricemia (data from a pilot study)

There are suggestions that Hyperuricemia (HU) can often accompany calcium pyrophosphate deposition (CPPD) disease and affect the clinical manifestations of it.

The aim was to determine the frequency of HU and its clinical significance in patients with CPPD.

Materials and Methods. The study included 213 patients with an established diagnosis of CPPD. The serum uric acid (sUA) level was determined in all patients, after which the patients were divided into 2 groups depending on the presence of sUA level (sUA level of ≥360 mmol/l was taken as HU): patients with CPPD and HU (n=75) and with CPPD and without HU (n=138). A comparative characteristic of the groups was carried out according to the clinical manifestations of the disease, comorbidity, therapy taken, and laboratory blood parameters.

Results. The groups did not differ in age. HU was detected in 75 out of 213 patients (35.2 %). The average sUA level in the group with CPPD and HU was 444.6±77.7 mmol/l, in the group with CPPD without HU – 273.2±53.0 mmol/l. In patients with CPPD and HU, chronic kidney disease was more frequently detected (18.7 % vs 8.7 %) and increased parathyroid hormone level (39.0 [29.8; 61.0] pmol/l vs 29.8 [18.4; 41.5] pmol/l). Hypertension, chronic heart failure (CHF), diabetes mellitus (DM) (for all p<0.05), and obesity (p<0,01) were also more frequently detected with CPPD and HU. Among the patients with CPPD and HU there were more people with chronic arthritis (60.0 % vs 45.0 %), and their ankle joints were more often involved (24.0 % vs 13.0 %). The median serum c-reactive protein level was also higher (3.8 [1.7; 6.7] mg/l vs. 2.1 [0.8; 5.9] mg/l).

Conclusion. The high frequency of HU in CPPD (35.2 %) and their combination with each other determines the high probability of comorbidity and metabolic disorders (obesity, hypertension, CHF, DM), and also creates conditions for the development of chronic inflammation.

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