Basic Calcium Phosphate Crystal Periarthritis Involving the Distal Interphalangeal Joints in a Patient with Systemic Lupus Erythematosus
Identifieur interne : 000A09 ( Main/Merge ); précédent : 000A08; suivant : 000A10Basic Calcium Phosphate Crystal Periarthritis Involving the Distal Interphalangeal Joints in a Patient with Systemic Lupus Erythematosus
Auteurs : Linett Martirossian ; Andreea M. Bujor ; Eugene KissinSource :
- The American Journal of Case Reports [ 1941-5923 ] ; 2019.
Abstract
Increased serum levels of basic calcium phosphate (BCP) and calcium pyrophosphate (CPP) are found in patients on dialysis, following trauma, and are associated with connective tissue diseases (CTDs), including dermatomyositis, scleroderma, and systemic lupus erythematosus (SLE). The shoulder is the joint most commonly associated with BCP crystal periarthritis. A report is presented of a case of BCP crystal periarthritis involving the distal interphalangeal (DIP) joints in a patient with SLE.
A 34-year-old woman with SLE presented with destructive arthritis of the DIP joints that developed during a two-year period, despite immunosuppressive therapy. Aspiration of synovial fluid from a DIP joint showed a lack of inflammatory cells, but the fluid was positive for the presence of crystals on alizarin red S histochemical staining.
A case of BCP crystal periarthritis is reported in a patient with SLE with chronic joint symptoms that were unresponsive to immunosuppressive therapy. This case has shown that chronic joint symptoms that are unresponsive to immunosuppressive therapy may be due to causes other than connective tissue disease (CTD) and that imaging studies and diagnostic workup that includes synovial fluid examination may support the diagnosis of BCP crystal periarthritis.
Url:
DOI: 10.12659/AJCR.916118
PubMed: 31366882
PubMed Central: 6690217
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<author><name sortKey="Martirossian, Linett" sort="Martirossian, Linett" uniqKey="Martirossian L" first="Linett" last="Martirossian">Linett Martirossian</name>
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<author><name sortKey="Bujor, Andreea M" sort="Bujor, Andreea M" uniqKey="Bujor A" first="Andreea M." last="Bujor">Andreea M. Bujor</name>
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<author><name sortKey="Kissin, Eugene" sort="Kissin, Eugene" uniqKey="Kissin E" first="Eugene" last="Kissin">Eugene Kissin</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Basic Calcium Phosphate Crystal Periarthritis Involving the Distal Interphalangeal Joints in a Patient with Systemic Lupus Erythematosus</title>
<author><name sortKey="Martirossian, Linett" sort="Martirossian, Linett" uniqKey="Martirossian L" first="Linett" last="Martirossian">Linett Martirossian</name>
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<author><name sortKey="Bujor, Andreea M" sort="Bujor, Andreea M" uniqKey="Bujor A" first="Andreea M." last="Bujor">Andreea M. Bujor</name>
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<author><name sortKey="Kissin, Eugene" sort="Kissin, Eugene" uniqKey="Kissin E" first="Eugene" last="Kissin">Eugene Kissin</name>
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<series><title level="j">The American Journal of Case Reports</title>
<idno type="eISSN">1941-5923</idno>
<imprint><date when="2019">2019</date>
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<front><div type="abstract" xml:lang="en"><p><bold>Patient: Female, 34</bold>
</p>
<p><bold>Final Diagnosis: Basic calcium phosphate arthropathy</bold>
</p>
<p><bold>Symptoms: —</bold>
</p>
<p><bold>Medication: —</bold>
</p>
<p><bold>Clinical Procedure: —</bold>
</p>
<p><bold>Specialty: Rheumatology</bold>
</p>
<sec><title>Objective:</title>
<p><bold>Rare co-existance of disease or pathology</bold>
</p>
</sec>
<sec><title>Background:</title>
<p>Increased serum levels of basic calcium phosphate (BCP) and calcium pyrophosphate (CPP) are found in patients on dialysis, following trauma, and are associated with connective tissue diseases (CTDs), including dermatomyositis, scleroderma, and systemic lupus erythematosus (SLE). The shoulder is the joint most commonly associated with BCP crystal periarthritis. A report is presented of a case of BCP crystal periarthritis involving the distal interphalangeal (DIP) joints in a patient with SLE.</p>
</sec>
<sec><title>Case Report:</title>
<p>A 34-year-old woman with SLE presented with destructive arthritis of the DIP joints that developed during a two-year period, despite immunosuppressive therapy. Aspiration of synovial fluid from a DIP joint showed a lack of inflammatory cells, but the fluid was positive for the presence of crystals on alizarin red S histochemical staining.</p>
</sec>
<sec><title>Conclusions:</title>
<p>A case of BCP crystal periarthritis is reported in a patient with SLE with chronic joint symptoms that were unresponsive to immunosuppressive therapy. This case has shown that chronic joint symptoms that are unresponsive to immunosuppressive therapy may be due to causes other than connective tissue disease (CTD) and that imaging studies and diagnostic workup that includes synovial fluid examination may support the diagnosis of BCP crystal periarthritis.</p>
</sec>
</div>
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