Clinical

Rapid chondrolysis is rare complication of liver transplantation

Last Updated: 2006-02-01 12:47:05 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Rapid loss of articular cartilage in multiple joints unrelated to infection or inflammation appears to be a rare complication after liver transplantation, physicians in France report.

Although liver transplant recipients are at risk for osteoporotic vertebral fractures and aseptic avascular osteonecrosis, there have been no reports of rapid chondrolysis unrelated to infection or inflammation following organ transplantation, Dr. F. Liote, from Hopital Lariboisiere in Paris, and colleagues note in the January issue of the Annals of the Rheumatic Diseases.

Between 1984 and 2000, Dr. Liote's team treated four patients among 1260 liver transplant recipients who developed total joint space obliteration in several joints, including the hips, knees, ankles and shoulders. The abnormalities were evident 2-to-12 years after liver transplantation, with three-to-six joints affected in each patient.

The researchers ruled out diseases associated with severe joint destruction, including septic or inflammatory arthritis, neurological disease, calcium pyrophosphate dihydrate deposition disease, hydroxyapatite-associated arthritis, ochronosis, hemochromatosis, hemodialysis and avascular necrosis.

"The involvement of both weightbearing and non-weightbearing joints in these patients supports a systemic cause for the chondrolysis," the authors suggest. They posit that "metalloproteinase activation or an imbalance affecting intra-articular degradation/repair processes may be involved."

Ann Rheum Dis 2006;65:118-120.