1
|
Aljuhani F, Tournadre A, Tatar Z, Couderc M, Mathieu S, Malochet-Guinamand S, Soubrier M, Dubost JJ. The SAPHO syndrome: a single-center study of 41 adult patients. J Rheumatol 2014; 42:329-34. [PMID: 25512472 DOI: 10.3899/jrheum.140342] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The SAPHO syndrome (synovitis, acne, pustulosis, hyperostosis, osteitis) is a rare disease and only a few series have been published about it. We describe the experience of a rheumatology department with a focus on the therapeutic aspects. METHODS All cases of SAPHO fulfilling the Benhamou criteria and seen between 1992 and 2013 in our unit were retrospectively included. RESULTS Forty-one patients (11 men and 30 women) were included. The average age was 45 years (20-80 yrs) at the time of diagnosis. Nineteen patients had palmoplantar pustulosis, 3 had psoriasis vulgaris, 3 had severe acne, and 15 had no dermatological involvement. Bone symptoms involved mainly the anterior chest wall (n = 28, 68%), followed by the spine (n = 16, 39%) and sacroiliac joints (n = 12, 29%). Four patients had peripheral osteitis and 2 had mandibular osteitis. Ten patients had peripheral arthritis affecting mainly the knees and wrists. None of the 36 patients tested was HLA-B27-positive. At least a partial response was achieved with colchicine, methotrexate, or sulfasalazine in 0/6, 2/4, and 1/6 of patients, respectively. Antibiotic therapy (azithromycin, n = 7; doxycycline, n = 2) was effective in 2/9 patients. Pamidronate was prescribed in 26 patients with bone involvement and 18/22 patients evaluable at 6 months responded to this therapy. Two patients were treated with tumor necrosis factor blockers: 1 with infliximab and 1 with adalimumab, followed by etanercept. CONCLUSION Based on our experience, SAPHO can be diagnosed in the elderly. It was not associated with HLA-B27. Soft tissue involvement was common and the bisphosphonates were generally effective on bone involvement.
Collapse
Affiliation(s)
- Faisal Aljuhani
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Anne Tournadre
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Zuzana Tatar
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Marion Couderc
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Sylvain Mathieu
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Sandrine Malochet-Guinamand
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Martin Soubrier
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand
| | - Jean-Jacques Dubost
- From the Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France.F. Aljuhani, MD; A. Tournadre, MD; Z. Tatar, MD; M. Couderc, MD; S. Mathieu, MD; S. Malochet-Guinamand, MD; M. Soubrier, MD, PhD; J-J. Dubost, MD; Department of Rheumatology, Gabriel Montpied Hospital, Centre Hospitalier Universitaire de Clermont-Ferrand.
| |
Collapse
|
2
|
Gharsallah I, Souissi A, Dhahri R, Boussetta N, Sayeh S, Métoui L, Ajili F, Louzir B, Othmani S. [SAPHO syndrome]. Rev Med Interne 2014; 35:595-600. [PMID: 24797142 DOI: 10.1016/j.revmed.2013.12.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 09/29/2013] [Accepted: 12/21/2013] [Indexed: 10/25/2022]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome is a rare entity characterized by the association of heterogeneous osteoarticular and cutaneous manifestations that have for common denominator an aseptic inflammatory process. The etiopathogeny of this disease is still a matter of debate. Although it has been related to the spondylarthritis family, an infectious origin is suggested. Diagnosis is based on the presence of at least one of the three diagnostic criteria proposed by Kahn. The treatment includes NSAIDs, antibiotics, corticosteroids, methotrexate and more recently the bisphosphonates and the TNFα inhibitors.
Collapse
Affiliation(s)
- I Gharsallah
- Service de rhumatologie, hôpital militaire de Tunis, Tunis, Tunisie.
| | - A Souissi
- Service de dermatologie, hôpital militaire de Tunis, Tunis, Tunisie
| | - R Dhahri
- Service de rhumatologie, hôpital militaire de Tunis, Tunis, Tunisie
| | - N Boussetta
- Service de médecine interne, hôpital militaire de Tunis, Tunis, Tunisie
| | - S Sayeh
- Service de rhumatologie, hôpital militaire de Tunis, Tunis, Tunisie
| | - L Métoui
- Service de rhumatologie, hôpital militaire de Tunis, Tunis, Tunisie
| | - F Ajili
- Service de médecine interne, hôpital militaire de Tunis, Tunis, Tunisie
| | - B Louzir
- Service de médecine interne, hôpital militaire de Tunis, Tunis, Tunisie
| | - S Othmani
- Service de médecine interne, hôpital militaire de Tunis, Tunis, Tunisie
| |
Collapse
|