pyrophosphate and Hyperplasia

Varying combinations of acute inflammatory and/or chronic degenerative arthritis have been found to be associated with crystals of calcium pyrophosphate dihydrate (CPPD) and/or basic calcium phosphates (BCPs). Since the arthropathies associated with CPPDs and/or BCPs occur in older individuals, while diagnosis and treatment for monosodium urate monohydrate crystal deposition disease (gout) have become extremely precise and effective, joint problems associated with calcium crystals have become more common than those associated with monosodium urate monohydrate crystals. The classification, pathogenesis, clinical manifestations, and treatment of CPPD and BCP crystal deposition are discussed.

Topics: Aged; Anti-Inflammatory Agents; Arthritis; Calcium Phosphates; Calcium Pyrophosphate; Colchicine; Crystallization; Diphosphates; Female; Humans; Hyperplasia; Inflammation; Joint Diseases; Methods; Peptide Hydrolases; Radiography; Shoulder Joint; Syndrome; Synovial Membrane

Ventricular function was evaluated using radionuclide ventriculography in 27 children with oropharyngeal obstruction and clinical features of obstructive sleep apnea. Their mean age was 3.5 years (9 months to 7.5 years). Conventional clinical assessment did not detect cardiac involvement in 25 of 27 children; however, reduced right ventricular ejection fraction (less than 35%) was found in 10 (37%) patients (mean: 19.5 +/- 2.3% SE, range: 8-28%). In 18 patients wall motion abnormality was detected. In 11 children in whom radionuclide ventriculography was performed before and after adenotonsillectomy, right ventricular ejection fraction rose from 24.4 +/- 3.6% to 46.7 +/- 3.4% (P less than 0.005), and in all cases wall motion showed a definite improvement. In five children, left ventricular ejection fraction rose greater than 10% after removal of oropharyngeal obstruction. It is concluded that right ventricular function may be compromised in children with obstructive sleep apnea secondary to adenotonsillar hypertrophy, even before clinical signs of cardiac involvement are present.

Topics: Adenoids; Child; Child, Preschool; Diphosphates; Erythrocytes; Female; Heart; Humans; Hyperplasia; Infant; Male; Myocardial Contraction; Palatine Tonsil; Radionuclide Imaging; Sleep Apnea Syndromes; Stroke Volume; Technetium; Technetium Tc 99m Pyrophosphate

Topics: Adolescent; Diphosphates; Female; Humans; Hyperplasia; Mandibular Condyle; Osteogenesis; Radionuclide Imaging; Technetium