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ARTICLE |

Arthritis Associated With Calcium Oxalate Crystals in an Anephric Patient Treated With Peritoneal Dialysis FREE

Ann Rosenthal, MD; Lawrence M. Ryan, MD; Daniel J. McCarty, MD
[+] Author Affiliations

Reprint requests to Department of Medicine, Medical College of Wisconsin, 8700 W Wisconsin Ave, Box 118, Milwaukee, WI 53226 (Dr Rosenthal).


JAMA. 1988;260(9):1280-1282. doi:10.1001/jama.1988.03410090112041
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We report a case of calcium oxalate arthropathy in a woman undergoing intermittent peritoneal dialysis who was not receiving pharmacologic doses of ascorbic acid. She developed acute arthritis, with calcium oxalate crystals in Heberden's and Bouchard's nodes, a phenomenon previously described in gout. Intermittent peritoneal dialysis may be less efficient than hemodialysis in clearing oxalate, and physicians should now consider calcium oxalate-associated arthritis in patients undergoing peritoneal dialysis who are not receiving large doses of ascorbic acid.

(JAMA 1988;260:1280-1282)

REFERENCES

Hoffman GS, Schumacher HR, Paul H, et al:  Calcium oxalate microcrystaline-associated arthritis in end stage renal disease . Ann Intern Med 1982;;97:36-42.
Reginato AJ, Secane JLF, Alvarez CB, et al:  Arthropathy and cutaneous calcinosis in hemodialysis oxalosis . Arthritis Rheum 1986;;29:1387-1396.
Schumacher HR Jr, Reginato AJ, Pullnan S:  Synovial fluid oxalate deposition complicating rheumatoid arthritis with amyloidosis and renal failure: Demonstration of intracellular oxalate crystals . J Rheum 1987;;14:361-366.
Weissner JH, Mandel GS, Mandel NS:  Membrane interactions with calcium oxalate crystals: Variation in hemolytic potentials with crystal morphology . J Urol 1986;;135:835-839.
Worcester EM, Nakagawa Y, Bushinsky DA, et al:  Evidence that serum oxalate supersaturation is a consequence of oxalate retention in patients with chronic renal failure . J Clin Invest 1986;;77:18881896.
Fayemi AO, Ali M, Braun EV:  Oxalosis in hemodialysis patients . Arch Pathol Lab Med 1979;;103:58-62.
Salyer WR, Keren D:  Oxalosis as a complication of chronic renal failure . Kidney Int 1973;;4:61-66.
Faires JS, McCarty DJ Jr:  Acute arthritis in man and dog after intrasynovial injection of sodium urate crystals . Lancet 1962;;2:682.
Phelps P, McCarty DJ Jr:  Crystal induced inflammation in canine joints: II. Importance of polymorphonuclear leukocytes . J Exp Med 1966;;124:115-125.
Simkin PA, Campbell PM, Larson EB:  Gout in Heberden's nodes . Arthritis Rheum 1983;;26:94.
Doherty M, Dieppe P:  Crystal deposition in the elderly . Clin Rheum Dis 1986;;12:97-116.
Simkin PA:  The pathogenesis of podagra . Ann Intern Med 1977;;86:230-233.
Loeb JN:  The influence of temperature on the solubility of monosodium urate . Arthritis Rheum 1972;;15:189-192.

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Hoffman GS, Schumacher HR, Paul H, et al:  Calcium oxalate microcrystaline-associated arthritis in end stage renal disease . Ann Intern Med 1982;;97:36-42.
Reginato AJ, Secane JLF, Alvarez CB, et al:  Arthropathy and cutaneous calcinosis in hemodialysis oxalosis . Arthritis Rheum 1986;;29:1387-1396.
Schumacher HR Jr, Reginato AJ, Pullnan S:  Synovial fluid oxalate deposition complicating rheumatoid arthritis with amyloidosis and renal failure: Demonstration of intracellular oxalate crystals . J Rheum 1987;;14:361-366.
Weissner JH, Mandel GS, Mandel NS:  Membrane interactions with calcium oxalate crystals: Variation in hemolytic potentials with crystal morphology . J Urol 1986;;135:835-839.
Worcester EM, Nakagawa Y, Bushinsky DA, et al:  Evidence that serum oxalate supersaturation is a consequence of oxalate retention in patients with chronic renal failure . J Clin Invest 1986;;77:18881896.
Fayemi AO, Ali M, Braun EV:  Oxalosis in hemodialysis patients . Arch Pathol Lab Med 1979;;103:58-62.
Salyer WR, Keren D:  Oxalosis as a complication of chronic renal failure . Kidney Int 1973;;4:61-66.
Faires JS, McCarty DJ Jr:  Acute arthritis in man and dog after intrasynovial injection of sodium urate crystals . Lancet 1962;;2:682.
Phelps P, McCarty DJ Jr:  Crystal induced inflammation in canine joints: II. Importance of polymorphonuclear leukocytes . J Exp Med 1966;;124:115-125.
Simkin PA, Campbell PM, Larson EB:  Gout in Heberden's nodes . Arthritis Rheum 1983;;26:94.
Doherty M, Dieppe P:  Crystal deposition in the elderly . Clin Rheum Dis 1986;;12:97-116.
Simkin PA:  The pathogenesis of podagra . Ann Intern Med 1977;;86:230-233.
Loeb JN:  The influence of temperature on the solubility of monosodium urate . Arthritis Rheum 1972;;15:189-192.
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