Fever with acute arthritis in calcium pyrophosphate dihydrate deposition disease: A missed explanation for altered mental status in elderly patients?

Citation
Jt. Kelley et al., Fever with acute arthritis in calcium pyrophosphate dihydrate deposition disease: A missed explanation for altered mental status in elderly patients?, JCR-J CLIN, 7(5), 2001, pp. 322-325
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Rheumatology
Journal title
JCR-JOURNAL OF CLINICAL RHEUMATOLOGY
ISSN journal
1076-1608 → ACNP
Volume
7
Issue
5
Year of publication
2001
Pages
322 - 325
Database
ISI
SICI code
1076-1608(200110)7:5<322:FWAAIC>2.0.ZU;2-F
Abstract
Calcium pyrophosphate dihydrate (CPPD) deposition disease is a relatively c ommon condition primarily affecting the elderly. Various clinical presentat ions ranging from an acute arthritis resembling gout (pseudogout) to fever of unknown origin have been reported. We describe four elderly patients with fever and altered mental status. Eac h patient underwent an extensive unrevealing work-up. An acute arthritis mi ssed by the health-care team in their initial evaluation was later identifi ed, leading to rheumatologic consultation and subsequent diagnosis of CPPD disease after joint aspiration and synovial fluid analysis. Defervescence a nd resolution of mental status changes occurred after improvement of the ar thritis. Awareness that CPPD disease may present with systemic symptoms, including f ever and altered mental status, may assure careful examination of joints an d can prevent unnecessary testing and diagnostic delay.