pyrophosphate and Hypothyroidism

Topics: Calcium Pyrophosphate; Chondrocalcinosis; Crystallization; Diphosphates; Humans; Hyperparathyroidism; Hypothyroidism; Radiography

Inorganic pyrophosphate (PPi) levels were estimated by radiometric assay in urine and in synovial fluid (SF) from asymptomatic, nonarthritic knees of patients with untreated metabolic disease and normal controls. SF PPi was significantly elevated in patients with hyperparathyroidism (mean +/- SEM 19 +/- 3 microM; n = 9), hemochromatosis (23 +/- 5 microM; n = 6), and hypomagnesemia (27 +/- 0.1 microM; n = 2) compared with normal subjects (10 +/- 0.5 microM, n = 50), and was low in patients with hypothyroidism (4.2 +/- 2.3 microM; n = 11) (P less than 0.05 all comparisons). Urinary PPi was elevated only in those with hypophosphatasia. Local elevation of ionic PPi may be relevant to the mechanism of crystal formation in metabolic diseases predisposing to calcium pyrophosphate dihydrate (CPPD) crystal deposition. The finding of low SF PPi levels in patients with hypothyroidism further questions the association between this condition and CPPD.

Topics: Adult; Aged; Aged, 80 and over; Calcium Pyrophosphate; Creatinine; Crystallization; Diphosphates; Endocrine System Diseases; Female; Hemochromatosis; Humans; Hyperparathyroidism; Hypophosphatasia; Hypothyroidism; Magnesium Deficiency; Male; Metabolic Diseases; Middle Aged; Synovial Fluid

Topics: Animals; Calcium Pyrophosphate; Carpus, Animal; Chondrocalcinosis; Diphosphates; Dog Diseases; Dogs; Forelimb; Hypothyroidism; Male

Topics: Aged; Calcium Pyrophosphate; Chondrocalcinosis; Diphosphates; Humans; Hypothyroidism

Topics: Adult; Aged; Calcium Phosphates; Chondrocalcinosis; Diphosphates; Female; Humans; Hypothyroidism; Male; Middle Aged; Myxedema; Radiography; Retrospective Studies; Synovial Fluid

Twelve patients with severe hypothyroidism and rheumatic signs and symptoms were studied before or within four days of receiving thyroid replacement therapy. Eight patients had synovial effusions. Seven effusions were extremely viscous and six contained calcium pyrophosphate crystals. Leukocyte counts were less than 1,000/mm3, except in two patients during crystal-induced synovitis. "Bulge signs" were present but often sluggish, possibly because of the viscosity of the fluid. Flexor tendon sheath thickening, joint laxity and popliteal cysts were documented. All patients complained of generalized stiffness and two had proximal myopathy. Roentgenograms were obtained in 11 patients, and chondrocalcinosis was identified in seven. Needle synovial biopsy specimens in five patients showed only mild inflammation in the thick synovium. These findings can suggest hypothyroidism, a treatable disease, as the cause of musculoskeletal problems.

Topics: Aged; Calcium Phosphates; Chondrocalcinosis; Diphosphates; Female; Humans; Hyaluronic Acid; Hypothyroidism; Joint Diseases; Male; Middle Aged; Radiography; Rheumatic Diseases; Synovial Fluid; Synovial Membrane; Viscosity