Frequency and clinical characteristics of pseudogout complicated by acute stroke

Abstract

Background and Purpose: To investigate the association between acute stroke and pseudogout and to identify the clinical characteristics of pseudogout complicated by acute stroke. Methods: We retrospectively analyzed 391 patients with acute stroke and 597 patients with other diseases. We compared the frequency of pseudogout complication and the clinical features of pseudogout between the stroke patients and the non-stroke patients. Results: Of the 391 patients with stroke, 13 developed pseudogout. The frequency of pseudogout in the patients with stroke tended to be higher than that in the non-stroke patients (3.3% and 1.5%, respectively, p=0.08), and likewise in the analysis of the definite or probable cases defined by McCarty criteria for pseudogout, the frequency of pseudogout complication was significantly higher in the stroke patients than in the non-stroke patients (1.8% and 0.3%, respectively, p=0.03). In all the 13 pseudogout patients with stroke, pseudogout occurred when the patients were confined to bed or a wheelchair. Of those patients, four had pseudogout on the hemiparetic side, one had pseudogout affecting both sides, and eight developed pseudogout on the non-paralyzed limbs. Eight of thirteen patients were initially treated with antibiotics before the diagnosis of pseudogout was made since they were first considered as having infections. Conclusion: This study revealed that patients with acute stroke are likely to develop pseudogout, and the arthritis occurs not only on the hemiparetic limbs, but also on the non-paralyzed limbs. Physicians need to recognize the possibility of pseudogout as a cause of fever in patients with acute stroke.