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Abstract Number: 0669

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

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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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