Christina Petsch1, Elizabeth G Araujo1, Matthias Englbrecht1, Sara Bayat1, Alexander Cavallaro2, Axel J Hueber1, Michael Lell2, Georg Schett1, Bernhard Manger1, Juergen Rech3. 1. Department of Internal Medicine 3, Rheumatology and Immunology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. 2. Department of Radiology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. 3. Department of Internal Medicine 3, Rheumatology and Immunology, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany. Electronic address: juergen.rech@uk-erlangen.de.
Abstract
OBJECTIVES: To investigate the prevalence of monosodium urate (MSU) crystal deposits, indicative for gout, in a population of rheumatoid arthritis (RA) patients with concomitant hyperuricemia and to analyze the clinical and disease-specific characteristics of RA patients who exhibit MSU crystal deposits. METHODS: Overall, 100 consecutive patients with the diagnosis of RA and a serum urate level above 6mg/dl underwent dual energy computed tomography (DECT) of both feet and hands to search for MSU crystals in a prospective study between October 2011 and July 2013. Presence and extent of MSU crystal deposits on DECT was assessed by automated volume measurement. Demographic and disease-specific characteristics were recorded and included into two logistic regression models to test for the factors associated with MSU crystal deposits in RA. RESULTS: Hyperuricemic RA patients were mostly male (55%), over 60 years of age (63 ± 11 years), had established disease (8.7 ± 10.5 years) and a mean disease activity score 28 (DAS 28) of 3.2. In total, 20 out of 100 patients displayed MSU crystal deposits in DECT. Interestingly, the majority (70%) of the RA patients positive for MSU crystal deposits were seronegative RA patients. Hence, every third seronegative RA patient had MSU crystal deposits. According to logistic regression model analysis, seronegative status correlated positively with presence of urate deposits (p = 0.019). CONCLUSIONS: These data show that a considerable number of RA patients display periarticular MSU crystal deposits. Seronegative patients were shown to be predominantly affected with every third patient being positive for urate deposits.
OBJECTIVES: To investigate the prevalence of monosodium urate (MSU) crystal deposits, indicative for gout, in a population of rheumatoid arthritis (RA) patients with concomitant hyperuricemia and to analyze the clinical and disease-specific characteristics of RApatients who exhibit MSU crystal deposits. METHODS: Overall, 100 consecutive patients with the diagnosis of RA and a serum urate level above 6mg/dl underwent dual energy computed tomography (DECT) of both feet and hands to search for MSU crystals in a prospective study between October 2011 and July 2013. Presence and extent of MSU crystal deposits on DECT was assessed by automated volume measurement. Demographic and disease-specific characteristics were recorded and included into two logistic regression models to test for the factors associated with MSU crystal deposits in RA. RESULTS:Hyperuricemic RApatients were mostly male (55%), over 60 years of age (63 ± 11 years), had established disease (8.7 ± 10.5 years) and a mean disease activity score 28 (DAS 28) of 3.2. In total, 20 out of 100 patients displayed MSU crystal deposits in DECT. Interestingly, the majority (70%) of the RApatients positive for MSU crystal deposits were seronegative RApatients. Hence, every third seronegative RApatient had MSU crystal deposits. According to logistic regression model analysis, seronegative status correlated positively with presence of urate deposits (p = 0.019). CONCLUSIONS: These data show that a considerable number of RApatients display periarticular MSU crystal deposits. Seronegative patients were shown to be predominantly affected with every third patient being positive for urate deposits.
Authors: Andrew Chiou; Bryant R England; Harlan Sayles; Geoffrey M Thiele; Michael J Duryee; Joshua F Baker; Namrata Singh; Grant W Cannon; Gail S Kerr; Andreas Reimold; Angelo Gaffo; Ted R Mikuls Journal: Arthritis Care Res (Hoboken) Date: 2020-06-07 Impact factor: 4.794
Authors: Penny Wang; Stacy E Smith; Rajesh Garg; Fengxin Lu; Alyssa Wohlfahrt; Anarosa Campos; Kathleen Vanni; Zhi Yu; Daniel H Solomon; Seoyoung C Kim Journal: RMD Open Date: 2018-03-09