Calcium pyrophosphate crystal formation in aqueous solutions.

Pseudogout is characterized by the deposition of calcium pyrophosphate dihydrate, triclinic [CPPD(T)] and calcium pyrophosphate dihydrate, monoclinic [CPPD(M)] crystals in articular connective tissues. We studied aqueous solutions over a range of calcium chloride/sodium pyrophosphate concentrations to determine the ionic conditions under which these particular salts form. At 37 degrees C, CPPD(T) forms when [PPi]t greater than or equal to 10(-4), while formation of CPPD(M) occurs at 10(-3) M < [PPi]t less than or equal to 10(-2) M. When [Na+]t > 120 mM, calcium disodium pyrophosphates precipitate. With 1 mM Mg++, CPPD(M) forms at [PPi]t > 10(-3) M, mixed with a calcium magnesium pyrophosphate at [PPi]t greater than or equal to 10(-2) M. We conclude that CPPD(T) and CPPD(M) crystals form in a restricted ratio and range of [Ca++]t and [PPi]t and that other ions, particularly Mg++ and Na+, affect the nature of the crystal products formed.