Crystal shedding and acute pseudogout. An hypothesis based on a therapeutic failure.
Four patients with chondrocalcinosis of the knees volunteered for joint lavage. Preliminary experiments indicated that disodium EDTA and magnesium ions were potent solubilizers of CPPD crystals. The procedure was a therapeutic failure in that insignificant amounts of CPPD were removed and all 4 subjects developed postlavage attacks of pseudogout. It is hypothesized that the acute attack of pseudogout is a result of crystal shedding and may be triggered by any factor that enhances CPPD solubility.
D000208:Acute Disease; D002130:Calcium Phosphates / Q000378:metabolism; D002805:Chondrocalcinosis / Q000188:drug therapy / Q000209:etiology*; D003460:Crystallization; D011756:Diphosphates / Q000378:metabolism; D004492:Edetic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000378:metabolism; D008278:Magnesium Sulfate / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012995:Solubility; D013582:Synovial Fluid / Q000032:analysis; D007507:Therapeutic Irrigation / Q000009:adverse effects
D002130:Calcium Phosphates; D011756:Diphosphates; D008278:Magnesium Sulfate; D004492:Edetic Acid