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. 1983;42(Suppl 1):27–37. doi: 10.1136/ard.42.suppl_1.27

Pathogenesis of chondrocalcinosis and pseudogout. Metabolism of inorganic pyrophosphate and production of calcium pyrophosphate dihydrate crystals.

A Caswell, D F Guilland-Cumming, P R Hearn, M K McGuire, R G Russell
PMCID: PMC1035036  PMID: 6311118

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Alfrey A. C., Solomons C. C. Bone pyrophosphate in uremia and its association with extraosseous calcification. J Clin Invest. 1976 Mar;57(3):700–705. doi: 10.1172/JCI108327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Altman R. D., Muniz O. E., Pita J. C., Howell D. S. Articular chondrocalcinosis. Microanalysis of pyrophosphate (PPi) in synovial fluid and plasma. Arthritis Rheum. 1973 Mar-Apr;16(2):171–178. doi: 10.1002/art.1780160206. [DOI] [PubMed] [Google Scholar]
  3. Armstrong D., VanWormer D., Solomons C. C. Increased inorganic serum pyrophosphate in serum and urine of patients with osteogenesis imperfecta. Clin Chem. 1975 Jan;21(1):104–108. [PubMed] [Google Scholar]
  4. Baumann J. M., Bisaz S., Felix R., Fleisch H., Ganz U., Russell R. G. The role of inhibitors and other factors in the pathogenesis of recurrent calcium-containing renal stones. Clin Sci Mol Med. 1977 Aug;53(2):141–148. doi: 10.1042/cs0530141. [DOI] [PubMed] [Google Scholar]
  5. Bennett R. M., Lehr J. R., McCarty D. J. Crystal shedding and acute pseudogout. An hypothesis based on a therapeutic failure. Arthritis Rheum. 1976 Jan-Feb;19(1):93–97. doi: 10.1002/art.1780190116. [DOI] [PubMed] [Google Scholar]
  6. Bjelle A. Cartilage matrix in hereditary pyrophosphate arthropathy. J Rheumatol. 1981 Nov-Dec;8(6):959–964. [PubMed] [Google Scholar]
  7. Bjelle A., Edvinsson U., Hagstam A. Pyrophosphate arthropathy in two Swedish families. Arthritis Rheum. 1982 Jan;25(1):66–74. doi: 10.1002/art.1780250111. [DOI] [PubMed] [Google Scholar]
  8. Butterworth P. J. The pyrophosphatase activity of pig kidney alkaline phosphatase and its inhibition by magnesium ions and excess of pyrophosphate. Biochem J. 1968 Dec;110(4):671–675. doi: 10.1042/bj1100671. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Camerlain M., McCarty D. J., Silcox D. C., Jung A. Inorganic pyrophosphate pool size and turnover rate in arthritic joints. J Clin Invest. 1975 Jun;55(6):1373–1381. doi: 10.1172/JCI108056. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Camerlain M., Silcox D. C., Lawrence A. M., McCarty D. J., Jr Variation in plasma and urinary inorganic phosphate and pyrophosphate in normal subjects and in patients with acromegaly or osteoarthritis. J Rheumatol. 1980 May-Jun;7(3):365–374. [PubMed] [Google Scholar]
  11. Cook G. A., King M. T., Veech R. L. Changes in liver inorganic pyrophosphate content during ethanol metabolism. Adv Exp Med Biol. 1980;132:433–440. doi: 10.1007/978-1-4757-1419-7_43. [DOI] [PubMed] [Google Scholar]
  12. Cuervo L. A., Pita J. C., Howell D. S. Ultramicroanalysis of pH, p CO2 and carbonic anhydrase activity at calcifying sites in cartilage. Calcif Tissue Res. 1971;7(3):220–231. doi: 10.1007/BF02062609. [DOI] [PubMed] [Google Scholar]
  13. David D. S., Sakai S., Granda J., Cheigh J. S., Riggio R. R., Stenzel K. H., Rubin A. L. Role of pyrophosphate in renal osteodystrophy. Trans Am Soc Artif Intern Organs. 1973;19:440–445. doi: 10.1097/00002480-197301900-00076. [DOI] [PubMed] [Google Scholar]
  14. Dieppe P. A., Crocker P., Huskisson E. C., Willoughby D. A. Apatite deposition disease. A new arthropathy. Lancet. 1976 Feb 7;1(7954):266–269. doi: 10.1016/s0140-6736(76)91400-8. [DOI] [PubMed] [Google Scholar]
  15. Doherty M., Watt I., Dieppe P. A. Localised chondrocalcinosis in post-meniscectomy knees. Lancet. 1982 May 29;1(8283):1207–1210. doi: 10.1016/s0140-6736(82)92336-4. [DOI] [PubMed] [Google Scholar]
  16. Eade A. W., Swannell A. J., Williamson N. Pyrophosphate arthropathy in hypophosphatasia. Ann Rheum Dis. 1981 Apr;40(2):164–170. doi: 10.1136/ard.40.2.164. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Eaton H., Moss D. W. Partial purification and some properties of human bone alkaline phosphatase. Enzymologia. 1968 Jul 31;35(1):31–39. [PubMed] [Google Scholar]
  18. Eaton R. H., Moss D. W. Inhibition of the orthophosphatase and pyrophosphatase activities of human alkaline-phosphatase preparations. Biochem J. 1967 Mar;102(3):917–921. doi: 10.1042/bj1020917. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Felix R., Fleisch H. Properties of inorganic pyrophosphatase of pig scapula cartilage. Biochem J. 1975 Apr;147(1):111–118. doi: 10.1042/bj1470111. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Felix R., Fleisch H. Purification and heterogeneity of inorganic pyrophosphatase of pig scapula cartilage. Biochem J. 1975 Apr;147(1):103–109. doi: 10.1042/bj1470103. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Felix R., Fleisch H. Pyrophosphatase and ATPase of isolated cartilage matrix vesicles. Calcif Tissue Res. 1976 Nov 24;22(1):1–7. doi: 10.1007/BF02010340. [DOI] [PubMed] [Google Scholar]
  22. Felix R., Fleisch H. The effect of pyrophosphate and diphosphonates on calcium transport in red cells. Experientia. 1977 Aug 15;33(8):1003–1005. doi: 10.1007/BF01945933. [DOI] [PubMed] [Google Scholar]
  23. Felix R., Fleisch H. The pyrophosphatase and (Ca2+-Mg2+)-ATPase activity of purified calf bone alkaline phosphatase. Biochim Biophys Acta. 1974 May 20;350(1):84–94. doi: 10.1016/0005-2744(74)90205-8. [DOI] [PubMed] [Google Scholar]
  24. Flodgaard H., Fleron P. Thermodynamic parameters for the hydrolysis of inorganic pyrophosphate at pH 7.4 as a function of (Mg2+), (K+), and ionic strength determined from equilibrium studies of the reaction. J Biol Chem. 1974 Jun 10;249(11):3465–3474. [PubMed] [Google Scholar]
  25. Flodgaard H., Torp-Pedersen C. A calcium ion-dependent adenosine triphosphate pyrophosphohydrolase in plasma membrane from rat liver. Demonstration that the adenosine triphosphate analogues adenosine 5'-[betagamma-imido]triphosphate and adenosine 5'-[betagamma-methylene]-triphosphate are substrates for the enzyme. Biochem J. 1978 Jun 1;171(3):817–820. doi: 10.1042/bj1710817. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Fortuna R., Anderson H. C., Carty R. P., Sajdera S. W. Enzymatic characterization of the matrix vesicle alkaline phosphatase isolated from bovine fetal epiphyseal cartilage. Calcif Tissue Int. 1980;30(3):217–225. doi: 10.1007/BF02408631. [DOI] [PubMed] [Google Scholar]
  27. Furuyama S., Mitsuma M., Doi N., Sugiva H., Oyama S. Properties and distribution of inorganic pyrophosphatase in rabbit dental pulp. J Dent Res. 1977 Oct;56(10):1239–1244. doi: 10.1177/00220345770560102501. [DOI] [PubMed] [Google Scholar]
  28. Gaucher A., Faure G., Netter P., Pourel J., Duheille J. Identification des cristaux observés dans les arthropathies destructrices de la chondrocalcinose. Rev Rhum Mal Osteoartic. 1977 Jun;44(6):407–414. [PubMed] [Google Scholar]
  29. Grindey G. B., Nichol C. A. Micro procedure for determination of pyrophosphate and orthophosphate. Anal Biochem. 1970 Jan;33(1):114–119. doi: 10.1016/0003-2697(70)90444-6. [DOI] [PubMed] [Google Scholar]
  30. Guynn R. W., Veloso D., Lawson J. W., Veech R. L. The concentration and control of cytoplasmic free inorganic pyrophosphate in rat liver in vivo. Biochem J. 1974 Jun;140(3):369–375. doi: 10.1042/bj1400369. [DOI] [PMC free article] [PubMed] [Google Scholar]
  31. Hamilton E. B. Diseases associated with CPPD deposition disease. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):353–357. doi: 10.1002/1529-0131(197605/06)19:3+<353::aid-art1780190708>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  32. Hearn P. R., Russell R. G. Formation of calcium pyrophosphate crystals in vitro: implications for calcium pyrophosphate crystal deposition disease (pseudogout). Ann Rheum Dis. 1980 Jun;39(3):222–227. doi: 10.1136/ard.39.3.222. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Hefferan P. M., Howell R. R. Genetic evidence for the common identity of glucose-6-phosphatase, pyrophosphate-glucose phosphotransferase, carbamyl phosphate-glucose phosphotransferase and inorganic pyrophosphatase. Biochim Biophys Acta. 1977 Feb 28;496(2):431–435. doi: 10.1016/0304-4165(77)90325-7. [DOI] [PubMed] [Google Scholar]
  34. Hoffman G. S., Schumacher H. R., Paul H., Cherian V., Reed R., Ramsay A. G., Franck W. A. Calcium oxalate microcrystalline-associated arthritis in end-stage renal disease. Ann Intern Med. 1982 Jul;97(1):36–42. doi: 10.7326/0003-4819-97-1-36. [DOI] [PubMed] [Google Scholar]
  35. Howell D. S., Muniz O., Pita J. C., Enis J. E. Pyrophosphate release by osteoarthritis cartilage incubates. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):488–494. doi: 10.1002/1529-0131(197605/06)19:3+<488::aid-art1780190724>3.0.co;2-l. [DOI] [PubMed] [Google Scholar]
  36. Howell D. S., Pita J. C. Calcificaiton of growth plate cartilage with special reference to studies on micropuncture fluids. Clin Orthop Relat Res. 1976 Jul-Aug;(118):208–229. [PubMed] [Google Scholar]
  37. Jacobelli S., Kettlun A. M., Sapag-Hagar M. Inorganic pyrophosphatase activity of the synovial fluid. Kinetic and clinical study. Arthritis Rheum. 1978 May;21(4):447–452. doi: 10.1002/art.1780210408. [DOI] [PubMed] [Google Scholar]
  38. Jacobelli S., McCarty D. J., Silcox D. C., Mall J. C. Calcium pyrophosphate dihydrate crystal deposition in neuropathic joints. Four cases of polyarticular involvement. Ann Intern Med. 1973 Sep;79(3):340–347. doi: 10.7326/0003-4819-79-3-340. [DOI] [PubMed] [Google Scholar]
  39. Jung A., Russel R. G., Bisaz S., Morgan D. B., Fleisch H. Fate of intravenously injected pyrophosphate-32P in dogs. Am J Physiol. 1970 Jun;218(6):1757–1764. doi: 10.1152/ajplegacy.1970.218.6.1757. [DOI] [PubMed] [Google Scholar]
  40. KOHN N. N., HUGHES R. E., McCARTY D. J., Jr, FAIRES J. S. The significance of calcium phosphate crystals in the synovial fluid of arthritic patients: the "pseudogout syndrome". II. Identification of crystals. Ann Intern Med. 1962 May;56:738–745. doi: 10.7326/0003-4819-56-5-738. [DOI] [PubMed] [Google Scholar]
  41. Lawson J. W., Veech R. L. Effects of pH and free Mg2+ on the Keq of the creatine kinase reaction and other phosphate hydrolyses and phosphate transfer reactions. J Biol Chem. 1979 Jul 25;254(14):6528–6537. [PubMed] [Google Scholar]
  42. Lust G., Faure G., Netter P., Gaucher A., Seegmiller J. E. Evidence of a generalized metabolic defect in patients with hereditary chondrocalcinosis. Increased inorganic pyrophosphate in cultured fibroblasts and lymphoblasts. Arthritis Rheum. 1981 Dec;24(12):1517–1521. doi: 10.1002/art.1780241210. [DOI] [PubMed] [Google Scholar]
  43. Lust G., Faure G., Netter P., Seegmiller J. E. Increased pyrophosphate in fibroblasts and lymphoblasts from patients with hereditary diffuse articular chondrocalcinosis. Science. 1981 Nov 13;214(4522):809–810. doi: 10.1126/science.6270793. [DOI] [PubMed] [Google Scholar]
  44. Lust G., Nuki G., Seegmiller J. E. Inorganic pyrophosphate and proteoglycan metabolism in cultured human articular chondrocytes and fibroblasts. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):479–487. doi: 10.1002/1529-0131(197605/06)19:3+<479::aid-art1780190723>3.0.co;2-q. [DOI] [PubMed] [Google Scholar]
  45. Majeska R. J., Wuthier R. E. Studies on matrix vesicles isolated from chick epiphyseal cartilage. Association of pyrophosphatase and ATPase activities with alkaline phosphatase. Biochim Biophys Acta. 1975 May 23;391(1):51–60. doi: 10.1016/0005-2744(75)90151-5. [DOI] [PubMed] [Google Scholar]
  46. Maroudas A. Physicochemical properties of cartilage in the light of ion exchange theory. Biophys J. 1968 May;8(5):575–595. doi: 10.1016/S0006-3495(68)86509-9. [DOI] [PMC free article] [PubMed] [Google Scholar]
  47. Maroudas A. Transport of solutes through cartilage: permeability to large molecules. J Anat. 1976 Nov;122(Pt 2):335–347. [PMC free article] [PubMed] [Google Scholar]
  48. McCarty D. J. Calcium pyrophosphate dihydrate crystal deposition disease--1975. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):275–285. doi: 10.1002/1529-0131(197605/06)19:3+<275::aid-art1780190702>3.0.co;2-0. [DOI] [PubMed] [Google Scholar]
  49. McCarty D. J., Palmer D. W., Halverson P. B. Clearance of calcium pyrophosphate dihydrate crystals in vivo. I. Studies using 169Yb labeled triclinic crystals. Arthritis Rheum. 1979 Jul;22(7):718–727. doi: 10.1002/art.1780220705. [DOI] [PubMed] [Google Scholar]
  50. McCarty D. J., Silcox D. C., Coe F., Jacobelli S., Reiss E., Genant H., Ellman M. Diseases associated with calcium pyrophosphate dihydrate crystal deposition. Am J Med. 1974 May;56(5):704–714. doi: 10.1016/0002-9343(74)90638-x. [DOI] [PubMed] [Google Scholar]
  51. McCarty D. J., Solomon S. D., Warnock M. L., Paloyan E. Inorganic pyrophosphate concentrations in the synovial fluid of arthritic patients. J Lab Clin Med. 1971 Aug;78(2):216–229. [PubMed] [Google Scholar]
  52. McGuire M. B., Colman C. H., Baghat N., Russell R. G. Radiometric measurement of pyrophosphate in cell cultures. Biochem Soc Trans. 1980 Oct;8(5):529–530. doi: 10.1042/bst0080529. [DOI] [PubMed] [Google Scholar]
  53. McKeran R. O., Andrews T. M., Howell A., Gibbs D. A., Chinn S., Watts W. E. The diagnosis of the carrier state for the Lesch--Nyhan syndrome. Q J Med. 1975 Apr;44(174):189–205. [PubMed] [Google Scholar]
  54. Micheli A., Po J., Fallet G. H. Measurement of soluble pyrophosphate in plasma and synovial fluid of patients with various rheumatic diseases. Scand J Rheumatol. 1981;10(3):237–240. doi: 10.3109/03009748109095305. [DOI] [PubMed] [Google Scholar]
  55. Milazzo S. C., Ahern M. J., Cleland L. G., Henderson D. R. Calcium pyrophosphate dihydrate deposition disease and familial hypomagnesemia. J Rheumatol. 1981 Sep-Oct;8(5):767–771. [PubMed] [Google Scholar]
  56. Moss D. W., Eaton R. H., Smith J. K., Whitby L. G. Association of inorganic-pyrophosphatase activity with human alkaline-phosphatase preparations. Biochem J. 1967 Jan;102(1):53–57. doi: 10.1042/bj1020053. [DOI] [PMC free article] [PubMed] [Google Scholar]
  57. O'Duffy J. D. Hypophosphatasia associated with calcium pyrophosphate dihydrate deposits in cartilage. Report of a case. Arthritis Rheum. 1970 Jul-Aug;13(4):381–388. doi: 10.1002/art.1780130404. [DOI] [PubMed] [Google Scholar]
  58. Oyama S., Mitsuma M., Furuyama S. Separation of inorganic pyrophosphatase from alkaline phosphatase in rabbit dental pulp. Int J Biochem. 1981;13(1):105–107. doi: 10.1016/0020-711x(81)90142-7. [DOI] [PubMed] [Google Scholar]
  59. Pritzker K. P., Cheng P. T., Adams M. E., Nyburg S. C. Calcium pyrophosphate dihydrate crystal formation in model hydrogels. J Rheumatol. 1978 Winter;5(4):469–473. [PubMed] [Google Scholar]
  60. Raja K. B., Smith G. P., Peters T. J. Subcellular localization and properties of alkaline inorganic pyrophosphatase in human polymorphonuclear leucocytes. Clin Chim Acta. 1981 Nov 25;117(1):33–41. doi: 10.1016/0009-8981(81)90007-3. [DOI] [PubMed] [Google Scholar]
  61. Russell R. G., Bisaz S., Donath A., Morgan D. B., Fleisch H. Inorganic pyrophosphate in plasma in normal persons and in patients with hypophosphatasia, osteogenesis imperfecta, and other disorders of bone. J Clin Invest. 1971 May;50(5):961–969. doi: 10.1172/JCI106589. [DOI] [PMC free article] [PubMed] [Google Scholar]
  62. Russell R. G., Bisaz S., Fleisch H., Currey H. L., Rubinstein H. M., Dietz A. A., Boussina I., Micheli A., Fallet G. Inorganic pyrophosphate in plasma, urine, and synovial fluid of patients with pyrophosphate arthropathy (chondrocalcinosis or pseudogout). Lancet. 1970 Oct 31;2(7679):899–902. doi: 10.1016/s0140-6736(70)92070-2. [DOI] [PubMed] [Google Scholar]
  63. Russell R. G., Hodgkinson A. The urinary excretion of inorganic pyrophosphate by normal subjects and patients with renal calculus. Clin Sci. 1966 Aug;31(1):51–62. [PubMed] [Google Scholar]
  64. Russell R. G., Wadstrom L. B., Lindstedt S., Care A. D., Bisaz S., Fleisch H. The origin of inorganic pyrophosphate in urine. Clin Sci. 1969 Oct;37(2):419–429. [PubMed] [Google Scholar]
  65. Ryan L. M., Cheung H. S., McCarty D. J. Release of pyrophosphate by normal mammalian articular hyaline and fibrocartilage in organ culture. Arthritis Rheum. 1981 Dec;24(12):1522–1527. doi: 10.1002/art.1780241211. [DOI] [PubMed] [Google Scholar]
  66. Ryan L. M., Kozin F., McCarty D. J. Quantification of human plasma inorganic pyrophosphate. I. Normal values in osteoarthritis and calcium pyrophosphate dihydrate crystal deposition disease. Arthritis Rheum. 1979 Aug;22(8):886–891. doi: 10.1002/art.1780220812. [DOI] [PubMed] [Google Scholar]
  67. STETTEN D., Jr Biosynthesis and pyrophosphate. Am J Med. 1960 Jun;28:867–870. doi: 10.1016/0002-9343(60)90195-9. [DOI] [PubMed] [Google Scholar]
  68. Shatton J. B., Shah H., Williams A., Morris H. P., Weinhouse S. Activities and properties of inorganic pyrophosphate in normal tissues and hepatic tumors of the rat. Cancer Res. 1981 May;41(5):1866–1872. [PubMed] [Google Scholar]
  69. Silcox D. C., McCarty D. J., Jr Elevated inorganic pyrophosphate concentrations in synovial fluids in osteoarthritis and pseudogout. J Lab Clin Med. 1974 Apr;83(4):518–531. [PubMed] [Google Scholar]
  70. Sørensen S. A., Flodgaard H., Sørensen E. Serum alkaline phosphatase, serum pyrophosphatase, phosphorylethanolamine and inorganic pyrophosphate in plasma and urine. A genetic and clinical study of hypophosphatasia. Monogr Hum Genet. 1978;10:66–69. [PubMed] [Google Scholar]
  71. Tenenbaum J., Muniz O., Schumacher H. R., Good A. E., Howell D. S. Comparison of phosphohydrolase activities from articular cartilage in calcium pyrophosphate deposition disease and primary osteoarthritis. Arthritis Rheum. 1981 Mar;24(3):492–500. doi: 10.1002/art.1780240307. [DOI] [PubMed] [Google Scholar]
  72. Thuillier L. Purification and kinetic properties of human erythrocyte Mg2+-dependent inorganic pyrophosphatase. Biochim Biophys Acta. 1978 May 11;524(1):198–206. doi: 10.1016/0005-2744(78)90118-3. [DOI] [PubMed] [Google Scholar]
  73. Torp-Pedersen C., Flodgaard H., Saermark T. Studies on a Ca2+-dependent nucleoside triphosphate pyrophosphohydrolase in rat liver plasma membranes. Biochim Biophys Acta. 1979 Nov 9;571(1):94–104. doi: 10.1016/0005-2744(79)90229-8. [DOI] [PubMed] [Google Scholar]
  74. Tran T. T., Phillips J. W., Schulze-Specking A., Rasenack J., Decker K. Properties and biosynthetic connection of the nucleotide pyrophosphatases of rat liver plasma membrane and endoplasmic reticulum. Hoppe Seylers Z Physiol Chem. 1981 Mar;362(3):305–316. doi: 10.1515/bchm2.1981.362.1.305. [DOI] [PubMed] [Google Scholar]
  75. Volk S. E., Baykov A. A., Duzhenko V. S., Avaeva S. M. Kinetic studies on the interactions of two forms of inorganic pyrophosphatase of heart mitochondria with physiological ligands. Eur J Biochem. 1982 Jun 15;125(1):215–220. doi: 10.1111/j.1432-1033.1982.tb06671.x. [DOI] [PubMed] [Google Scholar]
  76. Wuthier R. E. Electrolytes of isolated epiphyseal chondrocytes, matrix vesicles, and extracellular fluid. Calcif Tissue Res. 1977 Jun 28;23(2):125–133. doi: 10.1007/BF02012777. [DOI] [PubMed] [Google Scholar]
  77. Yaron M., Zurkowski P., Weiser H. I., Yust I., Goldschmied A., Hermann E. Pseudogout with low values of alkaline phosphatase in the synovial fluid. Ann Intern Med. 1970 Nov;73(5):751–756. doi: 10.7326/0003-4819-73-5-751. [DOI] [PubMed] [Google Scholar]
  78. Zitnan D., Sitaj S. Natural course of articular chondrocalcinosis. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):363–390. [PubMed] [Google Scholar]
  79. van der Korst J. K., Geerards J. Articular chondrocalcinosis in a Dutch pedigree. Arthritis Rheum. 1976 May-Jun;19 (Suppl 3):405–409. doi: 10.1002/1529-0131(197605/06)19:3+<405::aid-art1780190713>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]

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