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Observational Study
. 2014 Jul 16;4(7):e005308.
doi: 10.1136/bmjopen-2014-005308.

Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study

Jane J Park  1 , Martine P Roudier  2 , Divya Soman  1 , Nahush A Mokadam  3 , Peter A Simkin  1
Affiliations
Observational Study

Prevalence of birefringent crystals in cardiac and prostatic tissues, an observational study

Jane J Park et al. BMJ Open. .

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.

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Figures

Figure 1
Figure 1
Intracellular negatively birefringent crystals in the intima of a left anterior descending artery (left) as seen with polarising microscopy. White arrow denotes a first-order red plate axis. Deconvolution confocal microscopy image of the same cell showing intracellular crystals (right).
Figure 2
Figure 2
Microtophus in the intima of a left anterior descending artery.
Figure 3
Figure 3
Microtophi in the adventitia of a right coronary artery.
Figure 4
Figure 4
Positively and negatively birefringent crystals within the prostate gland lumen.
See this image and copyright information in PMC

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