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06-09-2018 | Calcium crystal deposition disease | Review | Article

Calcium crystal deposition diseases — beyond gout

Journal: Nature Reviews Rheumatology

Authors: Geraldine M. McCarthy, Aisling Dunne

Publisher: Nature Publishing Group UK

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Abstract

The most common types of calcium-containing crystals that are associated with joint and periarticular disorders are calcium pyrophosphate dihydrate (CPP) and basic calcium phosphate (BCP) crystals. Several diverse but difficult-to-treat acute and chronic arthropathies and other clinical syndromes are associated with the deposition of these crystals. Although the pathogenic mechanism of calcium crystal deposition is partially understood, much remains to be investigated, as no drug is available to prevent crystal deposition, permit crystal dissolution or specifically target the pathogenic effects that result in the clinical manifestations. In this Review, the main clinical manifestations of CPP and BCP crystal deposition are discussed, along with the biological effects of these crystals, current therapeutic approaches and future directions in therapy.
Glossary
Chondrocalcinosis
Calcification of articular fibrocartilage or hyaline cartilage, most commonly owing to calcium pyrophosphate dihydrate crystal deposition.
Hypophosphatasia
A rare genetic disorder characterized by defective mineralization of bone and/or teeth caused by a deficiency of serum and bone alkaline phosphatase.
Gitelman variant of Bartter syndrome
A genetic renal disorder characterized by hypokalaemic alkalosis (low serum potassium levels) caused by inactivating mutations in a gene encoding a thiazide-sensitive sodium–chloride cotransporter (SLC12A3).
Birefringent
A state that enables a material of ordered structure to split a single ray of unpolarized light into two rays; the colour of the birefringent material changes as its orientation changes in relation to the light source.
Acetabular labrum
A ring of fibrous cartilage that surrounds the acetabulum (cup) of the hip joint.
Symphysis pubis
A cartilaginous joint located between the left and right pubic bones.
Annulus fibrosus
The outer layer of the intervertebral disc composed of strong layers of collagen fibres that surrounds the soft inner core of the disc.
Calciphylaxis
A rare and potentially fatal disease cause by the accumulation of calcium in small blood vessels of the fat and skin.
Crepitus
A medical term used to describe the cracking or popping sensation or sound that occurs when moving a joint; it is caused by the presence of air in the subcutaneous tissue.
Barbotage
Needle aspiration and lavage; it is used in the treatment of calcific tendinitis.
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