Why is hypophosphatemia a risk factor for pseudogout?

[Maxilla54]

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Why is hypophosphatemia a risk factor for pseudogout?
HypoMg is RF for pseudogout because it reduces CPPD solubility - is hypoPO4 working via a similar mechanism?

 

[DrStephenStrange]

Usually high phosphate levels can cause hypocalcemia due to negatively charged phosphate ions binding to positively charged Calcium ions. I'd imagine the opposite is also true. Hypercalcemia in turns can drive formation of more CPPD.

 

[Phloston]

Why is hypophosphatemia a risk factor for pseudogout?
HypoMg is RF for pseudogout because it reduces CPPD solubility - is hypoPO4 working via a similar mechanism?

Would have to mean calcium pyrophosphate is more likely to precipitate out in the setting of lower serum phosphate.

HY for USMLE are hereditary hemochromatosis and primary hyperparathyroidism as risk factors for pseudogout.

Pseudogout can present as an OA-like presentation in someone with either of the above conditions - i.e., you get an x-ray of the hands showing DIP involvement in someone with Bronze diabetes --> pseudogout, not OA. Or you'll just get a monoarthritis of a large joint such as the knee.

Risk factors for pseudogout such as hypothyroidism and Wilson disease I haven't seen across any NBME material.

 

[Maxilla54]

Thank you everyone 🙂