{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T07:04:27Z","timestamp":1791875067319,"version":"4.3.4"},"reference-count":15,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,12,5]],"date-time":"2020-12-05T00:00:00Z","timestamp":1607126400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The coexistence of calcium pyrophosphate dihydrate (CPPD) and monosodium urate monohydrate crystals in gouty tophi has rarely been reported. We undertook this study to investigate CPPD crystal deposits in a series of surgically removed gouty tophi and to identify factors associated with these deposits.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Twenty\u2010five tophi from 22 gout patients were analyzed using polarized light microscopy, field emission scanning electron microscopy (FESEM), and \u03bc Fourier transform infrared (\u03bcFTIR) spectroscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Tophi consisted of multiple lobules separated by fibrous septa and surrounded by a foreign\u2010body giant cell reaction. CPPD crystal aggregates were identified in 9 of 25 tophi from 6 patients. CPPD crystals were dispersed or highly compacted, localized at the edge or inside the tophus lobules, with some lobules completely filled with crystals. Both monoclinic and triclinic CPPD crystal phases were identified using FESEM and \u03bcFTIR. Compared to patients without CPPD, those with CPPD\u2010containing tophi were older (mean 60.5 years versus 47.2 years; <jats:italic>P<\/jats:italic> = 0.009), and had longer\u2010term gout duration (mean 17.0 years versus mean 9.0 years; <jats:italic>P<\/jats:italic> &lt; 0.05) and tophi duration (mean 10.0 years versus mean 4.6 years; <jats:italic>P<\/jats:italic> &lt; 0.01). None of the patients had radiographic chondrocalcinosis of the knee or wrist.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CPPD crystal formation seems to be a late and frequent event of tophus maturation, occurring more frequently with aging, and could contribute to the speed of tophus dissolution and the apparent persistence of tophus sometimes observed even after effective, long\u2010lasting urate\u2010lowering therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.41515","type":"journal-article","created":{"date-parts":[[2020,9,27]],"date-time":"2020-09-27T04:28:27Z","timestamp":1601180907000},"page":"324-329","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Calcium Pyrophosphate Dihydrate Crystal Deposition in Gouty Tophi"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2393-7475","authenticated-orcid":false,"given":"Hang\u2010Korng","family":"Ea","sequence":"first","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Gauffenic","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Quang Dinh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Vien Gut Medical Center and French\u2010Vietnamese Research Center on Gout and Chronic Diseases  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhu G.","family":"Pham","sequence":"additional","affiliation":[{"name":"Vien Gut Medical Center and French\u2010Vietnamese Research Center on Gout and Chronic Diseases  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oc\u00e9ane","family":"Olivier","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Frochot","sequence":"additional","affiliation":[{"name":"H\u00f4pital Tenon and Sorbonne Universit\u00e9 UMR S1155  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominique","family":"Bazin","sequence":"additional","affiliation":[{"name":"Institut de Chimie Physique Universit\u00e9 Paris\u2010Saclay CNRS UMR 8000  Orsay France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nghia H.","family":"Le","sequence":"additional","affiliation":[{"name":"Vien Gut Medical Center and French\u2010Vietnamese Research Center on Gout and Chronic Diseases  Ho Chi Minh City Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Marty","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agn\u00e8s","family":"Ostertag","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Cohen\u2010Solal","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris INSERM UMR 1132 H\u00f4pital Lariboisi\u00e8re AP\u2010HP  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Denis","family":"Laredo","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris and H\u00f4pital Lariboisi\u00e8re  Paris 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