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Update on Oxalate Crystal Disease

  • CRYSTAL ARTHRITIS (MH PILLINGER, SECTION EDITOR)
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Abstract

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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Acknowledgments

The authors gratefully acknowledge the support of the Rare Kidney Stone Consortium (U54KD083908), a part of NIH Rare Diseases Clinical Research Network (RDCRN), funded by the NIDDK and the NIH Office of Rare Diseases Research (ORDR); the Mayo Clinic O’Brien Urology Research Center (P50 DK083007) funded by the NIDDK; the Mayo Clinic Hyperoxaluria Center; and the Oxalosis and Hyperoxaluria Foundation.

Conflict of interest

Elizabeth C. Lorenz declares that she has no conflict of interest.

Claude J. Michet declares that he has no conflict of interest.

Dawn S. Milliner has had travel/accommodations expenses covered/reimbursed by the Oxalosis and Hyperoxaluria Foundation.

John C. Lieske declares that he has no conflict of interest.

Author information

Authors and Affiliations

  1. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA

    Elizabeth C. Lorenz, Dawn S. Milliner & John C. Lieske

  2. Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Clement J. Michet

  3. Renal Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, 200 1st St SW, Rochester, MN, 55905, USA

    John C. Lieske

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  1. Elizabeth C. Lorenz
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  2. Clement J. Michet
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  3. Dawn S. Milliner
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  4. John C. Lieske
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Correspondence to John C. Lieske.

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This article is part of the Topical Collection on Crystal Arthritis

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Lorenz, E.C., Michet, C.J., Milliner, D.S. et al. Update on Oxalate Crystal Disease. Curr Rheumatol Rep 15, 340 (2013). https://doi.org/10.1007/s11926-013-0340-4

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  • DOI: https://doi.org/10.1007/s11926-013-0340-4

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