Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Clin Exp Rheumatol. 2019 Mar-Apr;37(2):254-259. Epub 2018 Jul 19.
It is unclear whether attack recurrence rates are similar between acute calcium pyrophosphate (CPP) crystal arthritis and gout. This study compared the clinical features and recurrence rates of both conditions.
In this retrospective study, we reviewed 106 patients with acute CPP crystal arthritis (based on the presence of CPP crystals and/or chondrocalcinosis) and 173 patients with gout (based on the presence of monosodium urate crystals). We analysed clinical variables and compared them between the two conditions. We identified factors associated with the recurrence of acute CPP crystal arthritis.
Patients with acute CPP crystal arthritis were older (76.5 vs. 62 years, p<0.001) and female (69.8% vs. 6.9%, p<0.001); they had a lower body mass index (22.3 vs. 23.7, p=0.002), lower renal insufficiency rate (27.4% vs. 41.6%, p=0.016), and higher rate of preceding infection (22.6% vs. 11.0%, p=0.009) than those with acute gout. Recurrence rates were similar between the groups (19.1% vs. 22.9%, p=0.562). Use of proton pump inhibitors (PPIs) [hazard ratio (HR), 5.625; 95% CI, 1.672-18.925; p=0.005] and warfarin (HR, 7.301; 95% CI, 1.930-27.622; p=0.003) or exposure to chemotherapy (HR, 5.663; 95% CI, 1.180-27.169; p=0.03) were associated with acute CPP crystal arthritis recurrence.
Acute CPP crystal arthritis was more common than acute gout in older women with preserved renal function. Physicians should be aware of the association between recurrence and PPI, warfarin, or chemotherapy use in these patients.
目前尚不清楚急性焦磷酸钙（CPP）晶体关节炎和痛风的发作复发率是否相似。本研究比较了两种疾病的临床特征和复发率。
在这项回顾性研究中，我们回顾了 106 例急性 CPP 晶体关节炎患者（基于 CPP 晶体和/或软骨钙沉着症的存在）和 173 例痛风患者（基于单钠尿酸盐晶体的存在）。我们分析了临床变量，并比较了两种情况之间的差异。我们确定了与急性 CPP 晶体关节炎复发相关的因素。
急性 CPP 晶体关节炎患者年龄较大（76.5 岁比 62 岁，p<0.001），女性更多（69.8%比 6.9%，p<0.001）；他们的体重指数较低（22.3 比 23.7，p=0.002），肾功能不全发生率较低（27.4%比 41.6%，p=0.016），感染发生率较高（22.6%比 11.0%，p=0.009）。两组的复发率相似（19.1%比 22.9%，p=0.562）。质子泵抑制剂（PPIs）的使用[风险比（HR），5.625；95%置信区间，1.672-18.925；p=0.005]和华法林（HR，7.301；95%置信区间，1.930-27.622；p=0.003）或化疗暴露（HR，5.663；95%置信区间，1.180-27.169；p=0.03）与急性 CPP 晶体关节炎的复发有关。
在肾功能正常的老年女性中，急性 CPP 晶体关节炎比急性痛风更为常见。医生应注意这些患者中复发与 PPI、华法林或化疗使用之间的关系。
