Calcium Pyrophosphate Crystal Deposition in Gouty Tophi

Hang-Korng Ea¹, Alan Gauffenic², Quand Nguyen³, Nhu Pham³, Oceane Olivier², Vincent Frochot⁴, Dominique Bazin⁵, Nghia Le³, Caroline Marty², Agnès Ostertag², Martine Cohen-Solal¹, Jean-Denis Laredo⁶, Pascal Richette⁷ and Thomas Bardin⁸, ¹Université de Paris, INSERM UMR 1132, BIOSCAR, AP-HP, DMU Locomoteur, Paris, France, ²Université de Paris, INSERM UMR 1132, BIOSCAR, Paris, France, ³Vien Gut Medical Center and French-Vietnamese research center on gout and chronic diseases, Ho Chi Ming, Vietnam, ⁴Hôpital Tenon, Service des explorations fonctionnelles multidisciplinaires, Sorbonne université, UMR_S1155, Paris, France, ⁵Institut de Chimie Physique, Université Paris-Saclay et CNRS - UMR8000, Orsay, France, ⁶AP-HP Université de Paris, Paris, ⁷Department of Rheumatology, Lariboisière Hospital, AP-HP Université de Paris, INSERM U1132, Paris, ⁸Université de Paris, INSERM U1132 and Hôpital Lariboisièe, Paris, France, Paris, France

Meeting: ACR Convergence 2020

Keywords: CPPD, Erosions, gout, macrophages

Session Information

Date: Saturday, November 7, 2020

Session Title: Metabolic & Crystal Arthropathies Poster

Session Type: Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: The coexistence of calcium pyrophosphate (CPP) and monosodium urate crystals is rarely reported in gouty tophi. We investigated CPP crystal deposits in a series of gouty tophi removed by surgery and associated factors.

Methods: 25 tophi from 22 patients were analyzed by light microscopy, field-emission-scanning electron microscopy (FE-SEM) and µ Fourier transform infrared (FTIR) spectroscopy

Results:

Tophi consisted of multiple lobules separated by fibrous septa and surrounded by a foreign-body giant cell reaction. CPP crystal aggregates were identified in 8 of 25 tophi from 5 patients. CPP crystals were dispersed or highly compacted, localized at the edge or inside the tophus lobules or filled some of them. Both monoclinic and triclinic CPP crystal phases were identified by FE-SEM and µ FTIR. As compared with patients without CPP, those with CPP-containing tophi were older (mean 61.2 vs 47.8 years, p=0.009), and had long-term gout (mean 19.0 vs 9.0 years, p=0.007) and tophus (mean 11.4 vs 4.7 years, p< 0.0001). None had radiological chondrocalcinosis of the knee or wrist

Conclusion: CPP crystal formation seems to be a late and frequent event of tophus maturation and could contribute to the apparent persistence of tophus sometimes observed even after long-lasting and efficient urate-lowering therapy.

Disclosure: H. Ea, None; A. Gauffenic, None; Q. Nguyen, None; N. Pham, None; O. Olivier, None; V. Frochot, None; D. Bazin, None; N. Le, None; C. Marty, None; A. Ostertag, None; M. Cohen-Solal, None; J. Laredo, None; P. Richette, None; T. Bardin, None.

To cite this abstract in AMA style:

Ea H, Gauffenic A, Nguyen Q, Pham N, Olivier O, Frochot V, Bazin D, Le N, Marty C, Ostertag A, Cohen-Solal M, Laredo J, Richette P, Bardin T. Calcium Pyrophosphate Crystal Deposition in Gouty Tophi [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/calcium-pyrophosphate-crystal-deposition-in-gouty-tophi/. Accessed May 16, 2022.

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