J Rheum Dis.  2014 Apr;21(2):82-86. 10.4078/jrd.2014.21.2.82.

A Case of Calcium Pyrophosphate Dihydrate Deposition Disease Associated with Primary Hyperparathyroidism

• Son CN
• Lee JY
• Kim D
• Joo KB
• Lee S
• Song YS
• Kim DS
• Tae K
• Yoo TS
• Jun JB

• KMID: 2094662
• DOI: http://doi.org/10.4078/jrd.2014.21.2.82

Abstract

Calcium pyrophosphate dihydrate (CPPD) deposition disease is a heterogeneous group of diseases with CPPD crystal deposition. Aging is the most common risk factor for CPPD deposition, followed by osteoarthritis and previous injury. Occasionally, CPPD depositions are associated with familial predisposition and metabolic diseases, including hemochromatosis, primary hyperparathyroidism, hypophosphatasia, and hypomagnesemia. CPPD deposition diseases associated with primary hyperparathyroidism in Koreans have rarely been reported. Thus, we report a case of a relatively young female patient with CPPD deposition disease associated with primary hyperparathyroidism, which was diagnosed through a polarized microscopic examination of the synovial fluid and a subtotal parathyroidectomy.

Keyword

Calcium pyrophosphate dihydrate deposition disease; Primary hyperparathyroidism

MeSH Terms

Aging
Calcium Pyrophosphate
Chondrocalcinosis*
Female
Hemochromatosis
Humans
Hyperparathyroidism, Primary*
Hypophosphatasia
Metabolic Diseases
Osteoarthritis
Parathyroidectomy
Risk Factors
Synovial Fluid
Calcium Pyrophosphate

Figure

• 

  Figure 1. Linear calcifications are seen within the medial and lateral joint space of both knees (A) and the hip joints (B).

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  Figure 2. Parathyroid specimen shows chief cell hyperplasia of parathyroid gland (H&E, ×200).

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  Figure 3. The graph shows the change of serum calcium level and parathyroid hormone level following parathyroidectomy (normal range: 8.4∼10.4 mg/dL, 15∼65 pg/mL, respectively). pre OP: pre-operation.

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