Calcium Pyrophosphate Deposition Disease in a Patient with Familial Hypokalemia-Hypomagnesemia (Gitelman’s-Syndrome): A Case Report – CPPD in Gitelman’s syndrome

Introduction

Calcium pyrophosphate deposition (CPPD) disease is a common arthropathy caused by the deposition of calcium pyrophosphate (CPP) crystals within articular and periarticular tissues [Rosenthal AK et al. N Engl J Med 2016; 374: 2575–2584]. In daily practice, CPPD disease may present with several clinical scenarios (asymptomatic chondrocalcinosis, osteoarthritis with chondrocalcinosis, acute CPP crystal arthritis, chronic CPP crystal arthritis and other rare variants, such as crowned dens syndrome) that may mimic different rheumatic conditions such as gout, rheumatoid arthritis, and polymyalgia rheumatica [Rosenthal AK et al. N Engl J Med 2016; 374: 2575–2584]. CPPD is most commonly idiopathic or secondary to osteoarthritis and/or prior joint injury. Its occurrence in patients younger than 55 years old can be linked to familial hereditary predisposition or associated with metabolic diseases (e. g. hypophosphatasia, hyperparathyroidism, hemochromatosis and hypomagnesemia) [Abhishek A et al. Clin Exp Rheumatol 2016; 34: 32–38].

In this paper, we describe a case of CPP chronic polyarthritis associated with Gitelman syndrome (GS) in a 56-year-old man, providing pictorial evidence of extensive and diffuse CPP crystal deposition in articular and periarticular structures.