Raza Mahanoor, Rana Masooma S, Arif Mobeena, Akinpelu Taofeek, Waheed Abdul
Family Medicine, WellSpan Good Samaritan Hospital, Lebanon, USA.
Family Medicine, Aga Khan University Hospital, Karachi, PAK.
Cureus. 2023 Feb 1;15(2):e34528. doi: 10.7759/cureus.34528. eCollection 2023 Feb.
Both gout and pseudogout are crystal-induced arthropathies. Here, we report a case of acute calcium pyrophosphate dihydrate (CPPD) arthritis associated with type 1 myocardial infarction (MI). An 83-year-old female presented to our emergency department with generalized weakness and bilateral lower extremity edema. Her left foot was noted to be more inflamed compared to the right, with cardinal signs of pain, swelling, erythema, and warmth. A presumptive diagnosis of cellulitis was made, and antibiotics were initiated. Further investigations revealed elevated troponins with new-onset bundle branch block, ST, and T-wave changes on electrocardiogram, indicating a type 1 MI. After a review of the patient's history, imaging of the extremity, elevated inflammatory markers, and the typical distribution and pattern of inflammation, the diagnosis was changed to pseudogout. Steroids and colchicine were initiated, providing instant relief. This case highlights a possible association between cardiovascular disease and pseudogout, emphasizing the need for further studies regarding this relationship. Despite being rare, physicians should be made aware of this relationship, especially in patients with a history of CPPD arthritis presenting with type 1 MI.
痛风和假性痛风均为晶体诱导的关节病。在此，我们报告一例与1型心肌梗死（MI）相关的急性二水焦磷酸钙（CPPD）关节炎病例。一名83岁女性因全身无力和双侧下肢水肿就诊于我院急诊科。发现其左脚比右脚炎症更重，有疼痛、肿胀、红斑和发热等主要体征。初步诊断为蜂窝织炎，并开始使用抗生素。进一步检查发现肌钙蛋白升高，心电图出现新发束支传导阻滞、ST段和T波改变，提示1型MI。在回顾患者病史、肢体影像学检查、炎症标志物升高以及典型的炎症分布和模式后，诊断改为假性痛风。开始使用类固醇和秋水仙碱，患者症状立即缓解。该病例突出了心血管疾病与假性痛风之间可能存在的关联，强调需要对这种关系进行进一步研究。尽管这种情况罕见，但医生应了解这种关系，尤其是在有CPPD关节炎病史且出现1型MI的患者中。
