Risk factors for Calcium pyrophosphate dihydrate development
What factors predispose patients to Calcium pyrophosphate dihydrate development?
• Idiopathic (sporadic): the greatest risk factors are advancing age (odds ratio [OR] 2.25 for each decade over age 40) and primary OA (OR 2.66). Sex and obesity are not risk factors.
• Consequence of mechanical joint trauma or meniscectomy (OR 5.0).
• Familial predisposition: in young-onset CPPD. Mutations at two genetic loci have been described in familial forms of CPPD: CCAL1 (gain-of-function mutation at TNFRSF11B gene; chromosome 5p) and CCAL2 (gain-of-function mutation at ANKH gene; chromosome 8q). These represent autosomal dominant forms of CPPD. Patients tend to present in their 20s and 30s and are more likely to have spinal involvement.
• Specific disease associations: primary hyperparathyroidism (OR 3.0), long-standing hypomagnesemia (OR 13.5), hypophosphatasia, and hemochromatosis. Other diseases have been associated with CPPD, but evidence is not as strong. CPPD is thought less likely to coexist with RA (OR 0.18), but more recent data challenges this assertion.
