TY  - JOUR
T1  - A Case of Pseudogout Successfully Treated with Prednisolone and Clarithromycin
AU  - Ohe, Masashi
PY  - 2023
DA  - July
DO  - 10.5505/achmedj.2023.36035
JF  - ACH Medical Journal
JO  - ACH Med J
PB  - Ankara Şehir Hastanesi
WT  - DergiPark
SN  - 2822-5872
SP  - 163
EP  - 164
VL  - 2
IS  - 3
LA  - en
AB  - To the Editor pseudogout (PG) is an acute arthritis induced by calcium pyrophosphate dihydrate crystal deposition, and it frequently develops in theelderly population. Non-steroidal anti-inflammatory drugs and/or corticosteroids, such as prednisolone (PSL), administered either by local intra-articular injection or systemic therapy remain the mainstay of PG treatment.1Macrolide antibiotics (MACs), such as clarithromycin (CAM) and azithromycin (AZM) provide not only antibacterial activity but also anti-inflammatory properties. Several recent studies reported the successful treatmentof rheumatoid arthritis2 and polymyalgia rheumatica3 using CAM as an anti-inflammatory agent. Herein, we describe a case of PG treated with PSLin combination with CAM, considering their anti-inflammatory properties.A 92-year-old female with Alzheimer’s disease, hypertension and osteoporosis presenting with fever, arthralgia and articular swellings in her bilateralshoulders, elbows, and wrists, was referred to our hospital. At the age of 91,she was diagnosed with PG by an orthopedic doctor. So far, she has experienced two PG attacks. The laboratory findings on this visit were as follows: white blood cell count, 8,990/μL (basophils, 0.3%; eosinophils, 1.0%;neutrophils, 78.4%; lymphocytes, 12.7%; and monocytes, 7.6%); C-reactive protein (CRP), 11.81 mg/dL; rheumatoid factor, 5 IU/L; anti-cyclic citrullinated peptide antibody, 0.5 U/mL; and antinuclear antibody titer, 1:40.A blood culture yielded negative results. No abnormal findings suggestiveof infection could be found in the systemic survey, including the chest roentgenogram and urinalysis. Bone roentgenogram revealed intra-articularcalcification compatible with PG. The aforementioned symptoms were similar to those of the previous PG attacks; therefore, the patient was diagnosed with PG attack. Initially, she was treated with acetaminophen (800mg/day), which was unsuccessful, although it was effective in the previousPG attacks. Therefore, she was treated with PSL (10 mg/day). Seven daysafter PSL treatment, fever and articular symptoms rapidly improved with adecreased CRP of 1.12 mg/dL. Therefore, the PSL dosage was decreasedto 7.5 mg/day. A week later, fever and articular symptoms relapsed with an
KW  - Pseudogout
KW  - Prednisolone
KW  - Clarithromycin
UR  - https://doi.org/10.5505/achmedj.2023.36035
L1  - https://dergipark.org.tr/en/download/article-file/3249444
ER  -