Journal List > J Rheum Dis > v.21(2) > 1064167

J Rheum Dis. 2014 Apr;21(2):82-86. Korean.
Published online April 30, 2014.
Copyright © 2014 by The Korean College of Rheumatology
A Case of Calcium Pyrophosphate Dihydrate Deposition Disease Associated with Primary Hyperparathyroidism
Chang-Nam Son,1 Ji-Young Lee,2 Dam Kim,2 Kyung-Bin Joo,3 Seunghun Lee,3 Young-Soo Song,4 Dong-Sun Kim,5 Kyung Tae,6 Tae-Seok Yoo,7 and Jae-Bum Jun2
1Division of Rheumatology, Department of Internal Medicine, Keimyung University Donsan Medical Center, Daegu, Korea.
2Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
3Department of Radiology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea.
4Department of Pathology, Hanyang University Hospital, Seoul, Korea.
5Division of Endoclinology, Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea.
6Department of Otolaryngology-Head and Neck Surgery, Hanyang University Hospital, Seoul, Korea.
7YTS Rheumatology Clinic, Seoul, Korea.

Corresponding to: Jae-Bum Jun, Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, 222, Wangsimni-ro, Seongdong-gu, Seoul 133-792, Korea. Email:
Received May 06, 2013; Revised June 10, 2013; Accepted June 17, 2013.

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.


Calcium pyrophosphate dihydrate (CPPD) deposition disease is a heterogeneous group of diseases with CPPD crystal deposition. Aging is the most common risk factor for CPPD deposition, followed by osteoarthritis and previous injury. Occasionally, CPPD depositions are associated with familial predisposition and metabolic diseases, including hemochromatosis, primary hyperparathyroidism, hypophosphatasia, and hypomagnesemia. CPPD deposition diseases associated with primary hyperparathyroidism in Koreans have rarely been reported. Thus, we report a case of a relatively young female patient with CPPD deposition disease associated with primary hyperparathyroidism, which was diagnosed through a polarized microscopic examination of the synovial fluid and a subtotal parathyroidectomy.

Keywords: Calcium pyrophosphate dihydrate deposition disease; Primary hyperparathyroidism


Figure 1
Linear calcifications are seen within the medial and lateral joint space of both knees (A) and the hip joints (B).
Click for larger image

Figure 2
Parathyroid specimen shows chief cell hyperplasia of parathyroid gland (H&E, ×200).
Click for larger image

Figure 3
The graph shows the change of serum calcium level and parathyroid hormone level following parathyroidectomy (normal range: 8.4~10.4 mg/dL, 15~65 pg/mL, respectively). pre OP: pre-operation.
Click for larger image

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