Artritis microcristalinas

  1. Garrote Corral, S.
  2. Zegarra Mondragón, S.
  3. Guillen Astete, C.
  4. Bachiller Corral, F.J.
Revista:
Medicine: Programa de Formación Médica Continuada Acreditado

ISSN: 0304-5412

Año de publicación: 2017

Serie: 12

Número: 27

Páginas: 1574-1585

Tipo: Artículo

DOI: 10.1016/J.MED.2017.02.003 DIALNET GOOGLE SCHOLAR

Otras publicaciones en: Medicine: Programa de Formación Médica Continuada Acreditado

Resumen

Introducción Las artritis microcristalinas engloban una grupo de patologías con una misma base fisiopatológica, el depósito a nivel articular y periarticular de cristales. Originada por depósito de cristales de urato monosódico. Clínica Puede presentarse en forma de mono, oligo o poliartritis y evolucionar tras episodios agudos a formas crónicas, por ello puede simular otras artropatías inflamatorias suponiendo en ocasiones un reto para el clínico. Diagnóstico Para llevar a cabo el diagnóstico es muy importante la identificación de cristales en el líquido sinovial. Tratamiento El tratamiento inicial consiste en abordar el brote agudo de inflamación en todos los casos, individualizando el tratamiento en función de las comorbilidades del paciente. Es fundamental normalizar de forma prolongada los niveles de uricemia para reducir los depósitos previos. Para ello, además de los tratamientos clásicos hipouricemiantes, como alopurinol, en los últimos años se están desarrollando otros tratamientos. Enfermedad por depósito de cristales de pirofosfato cálcico dihidratado Posee unas características clínicas y diagnósticas similares a la gota. Es más prevalente en pacientes de edad avanzada. No se ha demostrado ningún tratamiento eficaz para reabsorber los cristales y para la prevención de episodios agudos.

Referencias bibliográficas

  • Dalbeth N, Merriman TR, Stamp LK. Gout. Lancet. 2016;388(10055): 2039-52.
  • Kuo CF, Grainge MJ, Zhang W, Doherty M. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol. 2015;11(11):649-62.
  • Sicras-Mainar A, Navarro-Artieda R, Ibáñez-Nolla J. Resource use and economic impact of patients with gout: a multicenter, population-wide study. Reumatol Clin. 2013;9(2):94-100.
  • Chen C, Lü J-M, Yao Q. Hyperuricemia related diseases and xanthine oxidoreductase (xor) inhibitors: an overview. Med Sci Monit. 2016;22: 2501-12.
  • Pérez-Ruiz F, Dalbeth N, Bardin T. A review of uric acid, crystal deposition disease, and gout. Adv Ther. 2015;32(1):31-41.
  • Rock KL, Kataoka H, Lai J-J. Uric acid as a danger signal in gout and its comorbidities. Nat Rev Rheumatol. 2013;9(1):13-23.
  • Merriman TR, Choi HK, Dalbeth N. The genetic basis of gout. Rheum Dis Clin North Am. 2014;40(2):279-90.
  • Aune D, Norat T, Vatten LJ. Body mass index and the risk of gout: a systematic review and dose-response meta-analysis of prospective studies. Eur J Nutr. 2014;53(8):1591-601.
  • Gutman A. Gout. Textbook of medicine. 12ª ed. Philadelphia: WB Saunders; 1958. p. 595.
  • Vela Casasempere P. Manual SER de enfermedades reumáticas. 6a ed. Barcelona: Elsevier; 2014. p. 85-90.
  • Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006;54(8):2688-96.
  • Peláez-Ballestas I, Hernández Cuevas C, Burgos-Vargas R, Hernández Roque L, Terán L, Espinoza J. Diagnosis of chronic gout: evaluating the american college of rheumatology proposal, European league against rheumatism recommendations, and clinical judgment. J Rheumatol. 2010;37(8):1743-8.
  • Taylor WJ, Shewchuk R, Saag KG, Schumacher HR, Singh JA, Grainger R. Toward a valid definition of gout flare: results of consensus exercises using Delphi methodology and cognitive mapping. Arthritis Rheum. 2009;61(4):535-43.
  • Zhang W, Doherty M, Pascual E, Bardin T, Barskova V, Conaghan P. EULAR evidence based recommendations for gout. Part I: diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1301-11.
  • Chen LX, Schumacher HR. Current trends in crystal identification. Curr Opin Rheumatol. 2006;18(2):171-3.
  • Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yü TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977;20(3):895-900.
  • Richette P, Bardin T. Gout. Lancet. 2010;375(9711):318-28.
  • Pérez Ruiz F. Manual SER de Enfermedades Reumáticas. 6a ed. Barcelona: Elsevier; 2014. p. 489-95.
  • Malik A, Schumacher HR, Dinnella JE, Clayburne GM. Clinical diagnostic criteria for gout: comparison with the gold standard of synovial fluid crystal analysis. J Clin Rheumatol. 2009;15(1):22-4.
  • Martínez-Castillo A, Núñez C, Cabiedes J. Synovial fluid analysis. Reum Clin. 2010;6:316-21.
  • Gatter RA, Andrews RP, Cooley DA, Fiechtner JJ, Minna DA, Phelps P. American college of rheumatology guidelines for performing office synovial fluid examinations. J Clin Rheumatol. 1995;1(3):194-6.
  • Tsutani H, Yoshio N, Ueda T. Interleukin 6 reduces serum urate concentrations. J Rheumatol. 2000;27(2):554.
  • Durcan L, Grainger R, Keen HI, Taylor WJ, Dalbeth N. Imaging as a potential outcome measure in gout studies: A systematic literature review. Semin Arthritis Rheum. 2016;45(5):570-9.
  • Naredo E, Uson J, Jiménez-Palop M, Martínez A, Vicente E, Brito E. Ultrasound-detected musculoskeletal urate crystal deposition: which joints and what findings should be assessed for diagnosing gout? Ann Rheum Dis. 2013;
  • Das S, Ghosh A, Ghosh P, Lahiri D, Sinhamahapatra P, Basu K. Sensitivity and specificity of ultrasonographic features of gout in intercritical and chronic phase. Int J Rheum Dis. En prensa 2016.
  • Thiele RG, Schlesinger N. Ultrasonography shows disappearance of monosodium urate crystal deposition on hyaline cartilage after sustained normouricemia is achieved. Rheumatol Int. 2010;30(4):495-503.
  • Thiele RG, Schlesinger N. Diagnosis of gout by ultrasound. Rheumatol Oxf Engl. 2007;46(7):1116-21.
  • Furlow B. Dual-energy computed tomography. Radiol Technol. 2015; 86(3):301ct-21ct.
  • Guillen C, Grandal M, Velázquez C, Maldonado V, Vázquez M. Guía de manejo diagnóstico y terapéutico de la artritis séptica en urgencias. Arch Med. 2013;9(2):1-10.
  • Guillen Astete C, Medina Quiñones C, Bachiller Corral J. Valor de la procalcitonina en el diagnóstico diferencial de la monoartritis microcristalina e infecciosa. Emergencias. 2013;25:237-8.
  • Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castañeda-Sanabria J. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. En prensa 2016.
  • Kim KY, Ralph Schumacher H, Hunsche E, Wertheimer AI, Kong SX. A literature review of the epidemiology and treatment of acute gout. Clin Ther. 2003;25(6):1593-617.
  • Fravel MA, Ernst ME. Management of gout in the older adult. Am J Geriatr Pharmacother. 2011;9(5):271-85
  • Van Durme CMPG, Wechalekar MD, Buchbinder R, Schlesinger N, van der Heijde D, Landewé RBM. Non-steroidal anti-inflammatory drugs for acute gout. Cochrane Database Syst Rev. 2014;(9):CD010120.
  • Khanna PP, Gladue HS, Singh MK, FitzGerald JD, Bae S, Prakash S. Treatment of acute gout: a systematic review. Semin Arthritis Rheum. 2014;44(1):31-8.
  • Guillen Astete C, Boteanu A, Villarejo Botija M. Comparison of low doses of systemic corticosteroids therapy in diabetic partients with oligoarticular or polyarticular gout flares: an observational retrospective study. Ann Rheum Dis. 2016;75Suppl2:373.
  • Astete CAG, Boteanu A, Zea A. SAT0502 comparison between oral or intra-articular corticoids in the management of acute gout flare in patients with chronic renal failure. Ann Rheum Dis. 2014;73(Suppl 2):774-774.
  • Dumusc A, So A. Interleukin-1 as a therapeutic target in gout. Curr Opin Rheumatol. 2015;27(2):156-63.
  • Siegel LB, Alloway JA, Nashel DJ. Comparison of adrenocorticotropic hormone and triamcinolone acetonide in the treatment of acute gouty arthritis. J Rheumatol. 1994;21(7):1325-7.
  • Castrejon I, Toledano E, Rosario MP, Loza E, Pérez-Ruiz F, Carmona L. Safety of allopurinol compared with other urate-lowering drugs in pa-tients with gout: a systematic review and meta-analysis. Rheumatol Int. 2015;35(7):1127-37.
  • Reinders MK, Haagsma C, Jansen TLTA, van Roon EN, Delsing J, van de Laar M. A randomised controlled trial on the efficacy and tolerability with dose escalation of allopurinol 300-600 mg/day versus benz-bromarone 100-200 mg/day in patients with gout. Ann Rheum Dis. 2009; 68(6):892-7.
  • Chohan S. Safety and efficacy of febuxostat treatment in subjects with gout and severe allopurinol adverse reactions. J Rheumatol. 2011;38(9): 1957-9.
  • Reinders MK, van Roon EN, Jansen TLTA, Delsing J, Griep EN, Hoekstra M. Efficacy and tolerability of urate-lowering drugs in gout: a randomised controlled trial of benzbromarone versus probenecid after failure of allopurinol. Ann Rheum Dis. 2009;68(1):51-6.
  • Saag KG, Fitz-Patrick D, Kopicko J, Fung M, Bhakta N, Adler S. Lesinurad combined with allopurinol: randomized, double-blind, placebo-controlled study in gout subjects with inadequate response to standard of care allopurinol (a US-based study). Arthritis Rheumatol. En prensa 2016.
  • Zhang W, Doherty M, Bardin T, Barskova V, Guerne P-A, Jansen TL. European League Against Rheumatism recommenda-tions for calcium pyrophosphate deposition. Part I: terminology and diagnosis. Ann Rheum Dis. 2011;70(4):563-70.
  • Ea H-K, Lioté F. Diagnosis and clinical manifestations of calcium pyrophosphate and basic calcium phosphate crystal deposition diseases. Rheum Dis Clin North Am. 2014;40(2):207-29.
  • Abhishek A. Calcium pyrophosphate deposition disease: a review of epi-demiologic findings. Curr Opin Rheumatol. 2016;28(2):133-9.
  • Neame RL, Carr AJ, Muir K, Doherty M. UK community prevalence of knee chondrocalcinosis: evidence that correlation with osteoarthritis is through a shared association with osteophyte. Ann Rheum Dis. 2003; 62(6):513-8.
  • Felson DT, Anderson JJ, Naimark A, Kannel W, Meenan RF. The prevalence of chondrocalcinosis in the elderly and its association with knee osteoarthritis: the Framingham Study. J Rheumatol. 1989;16(9):1241-5.
  • Abhishek A, Doherty S, Maciewicz R, Muir K, Zhang W, Doherty M. Evidence of a systemic predisposition to chondrocalcinosis and associa-tion between chondrocalcinosis and osteoarthritis at distant joints: a cross-sectional study. Arthritis Care Res. 2013;65(7):1052-8.
  • Abhishek A, Doherty M. Epidemiology of calcium pyrophosphate crystal arthritis and basic calcium phosphate crystal arthropathy. Rheum Dis Clin North Am. 2014;40(2):177-91.
  • Doherty M, Watt I, Dieppe PA. Localised chondrocalcinosis in post-meniscectomy knees. Lancet Lond Engl. 1982;1(8283):1207-10.
  • Netter P, Bardin T, Bianchi A, Richette P, Loeuille D. The ANKH gene and familial calcium pyrophosphate dihydrate deposition disease. Jt Bone Spine Rev Rhum. 2004;71(5):365-8.
  • Rosenthal AK, Ryan LM. Calcium pyrophosphate deposition disease. N Engl J Med. 2016;374(26):2575-84.
  • Ea H-K, Lioté F. Advances in understanding calcium containing crystal disease. Curr Opin Rheumatol. 2009;21(2):150-7.
  • Roverano S, Ortiz AC, Ceccato F, Paira SO. Calcification of the transverse ligament of the atlas in chondrocalcinosis. J Clin Rheumatol. 2010; 16(1):7-9.
  • Magarelli N, Amelia R, Melillo N, Nasuto M, Cantatore F, Guglielmi G. Imaging of chondrocalcinosis: calcium pyrophosphate dihydrate (CPPD) crystal deposition disease -- imaging of common sites of involvement. Clin Exp Rheumatol. 2012;30(1):118-25.
  • Frediani B, Filippou G, Falsetti P, Lorenzini S, Baldi F, Acciai C. Diagnosis of calcium pyrophosphate dihydrate crystal deposition disease: ultrasonographic criteria proposed. Ann Rheum Dis. 2005;64(4):638-40.
  • Zhang W, Doherty M, Pascual E, Barskova V, Guerne P-A, Jansen TL. EULAR recommendations for calcium pyrophosphate deposition. Part II: management. Ann Rheum Dis. 2011;70(4):571-5.
  • Ali Y, Weinstein M, Jokl P. Acute pseudogout following intraarticular injection of high molecular weight hyaluronic acid. Am J Med. 1999; 107(6):641-2.
  • Ottaviani S, Brunier L, Sibilia J, Maurier F, Ardizzone M, Wendling D. Efficacy of anakinra in calcium pyrophosphate crystal-induced arthri-tis: a report of 16 cases and review of the literature. Joint Bone Spine. 2013;80(2):178-82.
  • Finckh A, Mc Carthy GM, Madigan A, Van Linthoudt D, Weber M, Neto D. Methotrexate in chronic-recurrent calcium pyrophosphate deposition disease: no significant effect in a randomized crossover trial. Arthritis Res Ther. 2014;16(5):458.
  • Terkeltaub R. Calcium crystal disease: calcium pyrophosphate dihydrate and basic calcium phosphate. Kelley’s textbook of rheumatology. 9ª ed. Philadelphia: Elsevier; 2012. p. 1576-96.
  • García GM, McCord GC, Kumar R. Hydroxyapatite crystal deposition disease. Semin Musculoskelet Radiol. 2003;7(3):187-93.