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Abstract Number: 233

Ultrasonographic Evaluation Of Patellar Cartilage and Triangular Fibrocartilage In Patients With Familial Benign Hypercalcemia

Alberto Batticciotto1, Diana Certan2, Valentina Varisco1, Marco Antivalle3, Fabiola Atzeni4, Maurizio Bevilacqua2 and Piercarlo Sarzi-Puttini4, 1Rheumatology, Rheumatology Unit, L. Sacco University Hospital, Milan, Italy, 2Endocrinology Unit, L. Sacco University Hospital, Milan, Italy, 3Rheumatology, L. Sacco University Hospital, Milano, Italy, 4Rheumatology Unit, L. Sacco University Hospital, Milan, Italy

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Deposition and ultrasonography

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Session Information

Title: Imaging of Rheumatic Diseases I: Imaging in Gout, Pediatric, Soft and Connective Tissue Diseases

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Familial benign hypercalcemia (FBH) is a rare autosomal dominant disease that is caused by a mutation in calcium sensing receptor (CaSR) genes and characterised by hypercalcemia and hypocalciuria with normal serum parathormone levels. The typical clinical symptoms are fatigue, weakness and polydipsia, but rare cases may be associated with chondrocalcinosis, pancreatitis and gallstones. One sensitive and specific means of diagnosis is an oral calcium and peptone load test.

The aim of this study was to evaluate the presence of calcium deposits in patellar cartilage and triangular fibrocartilage levels in FBH patients using the same ultrasonographic guidelines as those proposed for patients with gout and chondrocalcinosis.

Methods:

Twenty-three patients with FBH (2 M, 21F; mean age 69 yrs, range 51-85; mean serum ionised calcium level 1.33 mmol/L, range 1.2-1.5 ) and 22 controls (1 M, 20 F; mean age 68 yrs, range 45-89; mean serum ionised calcium level 1.1 mmol/L, range 1.1-1.3), with normal serum ionised calcium levels who had negative oral calcium and peptone load test results, were evaluated be means of patellar cartilage and triangular fibrocartilage ultrasonography (ESAOTE My Lab 70, linear probe 13-18 MHz).

Results:

The two groups were statistically similar in terms of age (p=0.709), serum parathormone levels (p=0.548), serum vitamin D levels (p=0.508) and calciuria levels (p=0.194), but different in terms of serum ionised calcium levels (p<0.001). Ultrasonography revealed microcrystalline deposits in at least one cartilage in  16/23 (69.6%) FBH patients and in 8/22 (36,4%) controls with a statistically significant difference (p=0.026).

Conclusion:

Patients with hypercalcemia due to FBH have a higher prevalence of ultrasonographically detectable microcrystalline deposits in patellar cartilage and triangular fibrocartilage than normocalcemic controls.

 

 

FBH

Control

Group

P

Age (yrs)

69 (range 51-85)

68 (range 45-89)

0.709

Parathormone  (pg/ml)

49,1 ± 11,4

46,67 ± 13,67

0.548

Ionised Calcium (mmol/L)

1.33 ± 0.6

1.18 ± 0.5

0.001

Vitamine D (ng/ml)

37.3 ± 13.6

40± 13.9

0.508

Calciuria /24h (mg/dl)

216 ± 120.8

170 ± 88.3

0.194



Disclosure:

A. Batticciotto,
None;

D. Certan,
None;

V. Varisco,
None;

M. Antivalle,
None;

F. Atzeni,
None;

M. Bevilacqua,
None;

P. Sarzi-Puttini,
None.

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