Announ N, Guerne P A
Division de rhumatologie, Département de médecine interne, HUG, 1211 Genève 14.
Rev Med Suisse. 2007 Mar 21;3(103):740-2, 744, 746.
CPPD deposition disease is a common and potentially severe arthropathy. Hyperparathyroidism, hemochromatosis and hypomagnesaemia can favour chondrocalcinosis and must be looked for in early disease (< or =60 years). Chondrocalcinosis can cause severe attacks of inflammatory arthritis (pseudogout) as well as various forms of chronic arthropathies including pseudo RA, pseudo OA and pseudo neuropathic joint disease. Diagnosis is based on synovial fluid analysis, (positively birefringent CPPD crystals) and X-rays (punctuated and linear radio densities in cartilage). NSAIDs and i.a. or systemic glucocorticoids are the most useful treatments. Colchicine can be effective in recurring pseudogout, and magnesium for attacks' prevention. Methotrexate proved effective in a small uncontrolled series, and can be used when other treatments fail.
焦磷酸钙沉积病是一种常见且可能严重的关节病。甲状旁腺功能亢进、血色素沉着症和低镁血症可促使软骨钙质沉着，在疾病早期（≤60岁）必须排查这些病因。软骨钙质沉着可引发炎症性关节炎的严重发作（假痛风）以及各种形式的慢性关节病，包括假性类风湿关节炎、假性骨关节炎和假性神经性关节病。诊断基于滑液分析（焦磷酸钙晶体呈正性双折射）和X线检查（软骨内有斑点状和线状放射性密度影）。非甾体抗炎药以及关节内注射或全身应用糖皮质激素是最有效的治疗方法。秋水仙碱对复发性假痛风可能有效，镁剂可预防发作。在一个小型非对照研究系列中，甲氨蝶呤被证明有效，当其他治疗无效时可使用。
