Case reportAnakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure
Section snippets
Case report
We describe the case of a 71-year-old man on hemodialysis for end-stage renal failure secondary to hypertensive and diabetic nephropathy. For 18 months, he had a history of several painful acute episodes of arthritis with severe disability leading to several hospitalizations. In addition, he also complained of pain in both wrists and ankles and the left hip. During the latest episode of acute arthritis, C-reactive protein (CRP) levels were elevated at 72 mg/L (normal <10), serum calcium was 2.43
Discussion
Chondrocalcinosis can cause severe acute attacks of inflammatory arthritis, as well as various forms of chronic arthropathies [7]. Treatments of acute attacks are very similar to those used in gout. However, as opposed to gout, there is no specific long-term therapy for the prevention of acute attacks and of chronic CPPD-associated arthropathies. Thus, the management of chondrocalcinosis is primarily based on symptomatic therapies such as NSAIDs, glucocorticoids (local or systemic), and
References (18)
- et al.
The inflammasome, autoinflammatory diseases, and gout
Joint Bone Spine
(2007) - et al.
The role of IL-1 and IL-1Ra in joint inflammation and cartilage degradation
Vitam Horm
(2006) - et al.
Generation of biologically active interleukin-1 beta by proteolytic cleavage of the inactive precursor
J Biol Chem
(1988) - et al.
The inflammasome: a molecular platform triggering activation of inflammatory caspases and processing of proIL-1beta
Mol Cell
(2002) - et al.
Inflammatory caspases: linking an intracellular innate immune system to autoinflammatory diseases
Cell
(2004) - et al.
Is IL-1 a good therapeutic target in the treatment of arthritis?
Best Pract Res Clin Rheumatol
(2006) - et al.
Renal effects of non-steroidal anti-inflammatory drugs and selective cyclooxygenase-2 inhibitors
Curr Pharm Des
(2005) - et al.
Colchicine prescribing and safety monitoring in patients with gout
N Z Med J
(2007) - et al.
Treating difficult crystal pyrophosphate dihydrate deposition disease
Curr Rheumatol Rep
(2008)
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