Update on oxalate crystal disease.
Update on oxalate crystal disease.
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DOI：
10.1007/s11926-013-0340-4
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发表时间：
2013-07
影响因子：
5
通讯作者：
Lieske JC
中科院分区：
文献类型：
--
作者：
Lorenz EC;Michet CJ;Milliner DS;Lieske JC
草酸盐关节病是一种罕见的关节炎，其特征是在滑液中沉积草酸钙晶体。这种情况通常发生在原发性或继发性高血氧症患者。原发性高草酸尿是一组导致内源性草酸过量产生的遗传性疾病，而继发性高草酸尿是由与脂肪吸收不良和饮食草酸吸收增加相关的胃肠道疾病引起的。在这两种情况下，草酸盐晶体可在肾脏中沉积，导致肾功能衰竭。由于草酸盐主要通过肾脏排出，它在肾功能衰竭时在全身积累，这种状态称为草酸中毒。受影响的器官包括骨骼、关节、心脏、眼睛和皮肤。由于患者可能在诊断出高草酸血症之前就已经出现肾功能衰竭和草酸中毒，因此在出现不明原因的软组织结晶沉积的患者中考虑高草酸血症是很重要的。治疗草化病的最好办法是预防。如果患者出现疾病晚期，草酸关节炎的治疗包括症状管理和控制潜在的疾病过程。
Oxalate arthropathy is a rare cause of arthritis characterized by deposition of calcium oxalate crystals within synovial fluid. This condition typically occurs in patients with underlying primary or secondary hyperoxaluria. Primary hyperoxaluria constitutes a group of genetic disorders resulting in endogenous overproduction of oxalate, whereas secondary hyperoxaluria results from gastrointestinal disorders associated with fat malabsorption and increased absorption of dietary oxalate. In both conditions oxalate crystals can deposit in the kidney leading to renal failure. Since oxalate is primarily renally eliminated, it accumulates throughout the body in renal failure, a state termed oxalosis. Affected organs can include bones, joints, heart, eyes and skin. Since patients can present with renal failure and oxalosis before the underlying diagnosis of hyperoxaluria has been made, it is important to consider hyperoxaluria in patients who present with unexplained soft tissue crystal deposition. The best treatment of oxalosis is prevention. If patients present with advanced disease, treatment of oxalate arthritis consists of symptom management and control of the underlying disease process.
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