Chronic calcium pyrophosphate crystal inflammatory arthritis induced by extreme hypomagnesemia in short bowel syndrome

dc.contributor.authorHahn, Markus
dc.contributor.authorRaithel, Martin
dc.contributor.authorHagel, Alexander
dc.contributor.authorBiermann, Teresa
dc.contributor.authorManger, Bernhard
dc.date.accessioned2012-12-21
dc.date.available2023-10-06T13:39:24Z
dc.date.created2012
dc.date.issued2012-12-21
dc.description.abstractBackground Short bowel syndrome (SBS) may induce a plethora of clinical symptoms ranging from underweight to nutrient-, vitamin- and electrolyte deficiencies. The objective of this case report is to illustrate how demanding the management of a 60 year old patient with SBS and recurrent joint attacks was for different medical disciplines. Case presentation The patient with SBS presented with a body mass index of 16.5 kg/m2 after partial jejunoileal resection of the small intestine with a six year long history of recurrent pain attacks in multiple peripheral joints, chronic diarrhoea and food intolerances. Pain attacks occurred 4–5 times a week with a median consumption of 15 mg prednisone per day. The interdisciplinary workup after several gastroenterologic, rheumatologic, radiologic, psychiatric and orthopedic consultations is shown including successful treatment steps. Clinical diagnosis revealed no systemic inflammatory disease, but confirmed extreme hypomagnesemia (0.2 mmol/l) after reproducible pathological magnesium resorption tests as causative for chronic calcium pyrophosphate crystal inflammatory arthritis (pseudogout, chondrocalcinosis). Multidisciplinary treatment included application of colchicines, parenteral nutrition and magnesium substitution, antiperistaltic agents and avoidance of intolerant foods. Normalization of magnesium levels and a marked remission of joint attacks were achieved after six months with significant reduction of prednisone to 1.5 mg/day. Conclusion Despite the rarity of this condition, it is important to know that hypomagnesaemia may be associated with calcium pyrophosphate crystal inflammatory arthritis (chondrocalcinosis) and that SBS patients may be prone to develop extreme hypomagnesaemia causing recurrent joint attacks without systemic inflammation.en
dc.identifier.citationBMC Gastroenterology 12.129 (2012): 21.12.2012 <http://www.biomedcentral.com/1471-230X/12/129/abstract>
dc.identifier.opus-id2768
dc.identifier.urihttps://open.fau.de/handle/openfau/2768
dc.identifier.urnurn:nbn:de:bvb:29-opus-40258
dc.language.isoen
dc.subjectSBS
dc.subjectHypomagnesemia
dc.subjectChondrocalcinosis
dc.subjectPseudogout
dc.subjectCPPD
dc.subject.ddcDDC Classification::6 Technik, Medizin, angewandte Wissenschaften :: 61 Medizin und Gesundheit :: 610 Medizin und Gesundheit
dc.titleChronic calcium pyrophosphate crystal inflammatory arthritis induced by extreme hypomagnesemia in short bowel syndromeen
dc.typearticle
dcterms.publisherFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
local.journal.titleBMC Gastroenterology 12.129 (2012): 21.12.2012 <http://www.biomedcentral.com/1471-230X/12/129/abstract>
local.sendToDnbfree*
local.subject.fakultaetMedizinische Fakultät / Medizinische Fakultät -ohne weitere Spezifikation-
local.subject.gnd-
local.subject.sammlungUniversität Erlangen-Nürnberg / Von der FAU geförderte Open Access Artikel / Von der FAU geförderte Open Access Artikel 2012
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