Comparison of gout and CPPD disease

Characteristic	Gout	CPPD disease
Prevalence	17 to 20 per 1000 individuals, largely adult men and postmenopausal women	<1 per 1000 individuals experience acute CPP crystal arthritis (pseudogout); CPPD disease is common in osteoarthritis and increases with age
Crystal chemistry	Monosodium urate	CPP dehydrate
Crystal appearance	Negatively birefringent; needle-shaped or rods	Weakly positively birefringent; rods or rhomboidal
Articular involvement	Monoarticular > oligoarticular; polyarticular <30%	Monoarticular > oligoarticular
Most frequently affected joints	First MTP joint	Knee, wrist, other
	Initially 50%
	Eventually 90%
	Ankle, knees, other
Predisposing conditions/risk factors	Hyperuricemia*, obesity, hypertension, hyperlipidemia, alcohol ingestion, lead ingestion, hereditary enzyme defect	Hemochromatosis, osteoarthritis, hypomagnesemia, hyperparathyroidism, hereditary (rare), and increased age
Therapeutic options	Acute gout attacks	Acute CPP crystal arthritis (pseudogout)
	NSAIDs, glucocorticoids, colchicine	NSAIDs, glucocorticoids, colchicine
	Chronic gout management	Chronic CPPD disease management
	Urate-lowering agents, colchicine	NSAIDs, colchicine
		DMARDs: hydroxychloroquine, methotrexate (no randomized trials showing clinical benefit)

CPPD: calcium pyrophosphate deposition; CPP: calcium pyrophosphate; Pseudogout: a descriptive term for the form of CPPD disease now classified as acute CPP crystal arthritis; MTP: metatarsophalangeal; NSAIDs: nonsteroidal antiinflammatory drugs; DMARDs: disease-modifying antirheumatic drugs.
* Drugs associated with hyperuricemia include diuretics, low-dose salicylates, nicotinic acid, cyclosporine, ethanol, and ethambutol.

Adapted from: Am J Med 1997; 103:68S.

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Comparison of gout and CPPD disease