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Rheumatology
Research
Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study
  1. Jane J Park1,
  2. Martine P Roudier2,
  3. Divya Soman1,
  4. Nahush A Mokadam3,
  5. Peter A Simkin1
  1. 1Department of Medicine (Rheumatology), University of Washington, Seattle, Washington, USA
  2. 2Ventana Medical Systems Inc, Tucson, Arizona, USA
  3. 3Department of Surgery (Cardiothoracic Surgery), University of Washington, Seattle, Washington, USA
  1. Correspondence to Dr Peter A Simkin; psimkin{at}uw.edu

Abstract

Introduction The prevalence of urate crystals in residual tissue samples from coronary arteries, aortic valves and prostate glands was assessed.

Methods Alcohol-fixed coronary arteries from 55 explanted hearts, alcohol-fixed aortic valves collected from 75 valve replacement surgeries and 40 frozen, unfixed prostate specimens resected during cancer surgery were examined for birefringent crystals with polarising microscopy.

Results In the 55 explanted hearts, 6 (10.9%) contained a coronary artery with birefringent crystals. One of the 75 aortic valves (1.4%) contained negatively and positively birefringent crystals. Nineteen of the 40 (47.5%) prostates contained birefringent crystals.

Conclusions We found that a remarkable percentage of coronary arteries and prostate specimens contained birefringent crystals. Crystal presence is an obvious prerequisite for possible crystal induced-inflammation in these tissues, just as similar crystals elicit a gouty inflammatory cascade in synovial joints. Further studies are necessary to determine whether urate crystals may play this role in these tissues and, if so, to establish whether urate-lowering therapy may be beneficial in prostatitis and coronary disease.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2014-005308

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