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Qiu C, Li M, Wu Q, Zhou J, Liu T, Li J, Liu J, Cheng L, Hong Y, Luo D, Yan J, Pan W, Wang Z, Wang Q, Liu X, Wang L. A statistical symptomatic evaluation on SAPHO syndrome from 56 cases of confirmed diagnosis and 352 cases of non-SAPHO involvement. Clin Rheumatol 2024; 43:1763-1775. [PMID: 38446355 DOI: 10.1007/s10067-024-06887-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 01/01/2024] [Accepted: 01/23/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVE To report a statistical evaluation of symptomatology based on 56 cases of SAPHO syndrome and 352 non-SAPHO involvement cases, to propose a symptomatic scoring system in consideration of early warning for SAPHO syndrome. METHODS A cohort comprising 56 subjects diagnosed with SAPHO syndrome was reported, as well as 352 non-SAPHO involvement cases, including their chief complaints, skin manifestations, radiological findings, and laboratory tests. We systematically reviewed previous published five representative huge cohorts from different countries to conclude several specific features of SAPHO by comparing with our case series. The score of each specific index is based on respective incidence and comparison of two cohorts was performed. RESULT In terms of complaint rates, all subjects of two cohorts suffered from osseous pain, which appeared in the anterior chest wall, spine, and limb which were calculated. In respect to dermatological lesions, SAPHO patients suffered from severe acne, and other patients (82.14%) accompanied with palmoplantar pustulosis. Having received radiological examinations, most SAPHO subjects rather than non-SAPHO involvement cases showed abnormal osteoarticular lesions under CT scanning and more detailed information under whole-body bone scintigraphy. Differences also emerged in elevation of inflammation values and rheumatic markers like HLA-B27. Based on our cases and huge cohorts documented, the early warning standard is set to be 5 scores. CONCLUSIONS SAPHO syndrome case series with 56 subjects were reported and an accumulative scoring system for the early reminder on SAPHO syndrome was proposed. The threshold of this system is set to be 5 points. Key Points • Fifty-six patients diagnosed by SAPHO syndrome with detailed symptoms and radiological findings were reported. • Comparison was made between the 56 SAPHO patients and 352 non-SAPHO involvement cases. • An accumulative scoring system for the early reminder on SAPHO syndrome was proposed and the threshold of this system is set to be five points.
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Affiliation(s)
- Cheng Qiu
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Manyu Li
- Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, People's Republic of China
- Department of Gastroenterology, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Qingrong Wu
- Department of Dermatology, Xiangya Hospital, Central South University, Changsha, Hunan, 410008, People's Republic of China
| | - Jian Zhou
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, People's Republic of China
| | - Tianyi Liu
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China
| | - Jinghang Li
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Jingwei Liu
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Lin Cheng
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Yu Hong
- Department of Radiology, the First Affiliated Hospital of Shandong First Medical University, Jinan, Shandong, 250014, People's Republic of China
| | - Dan Luo
- Department of Oral and Maxillofacial Surgery, the Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266003, People's Republic of China
| | - Jun Yan
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China
| | - Wenping Pan
- Department of Rheumatology and Autoimmunology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Medicine and Health Key Laboratory of Rheumatism, Jinan, Shandong, 250014, People's Republic of China
| | - Zhankui Wang
- Department of Rheumatology and Autoimmunology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Medicine and Health Key Laboratory of Rheumatism, Jinan, Shandong, 250014, People's Republic of China.
| | - Qing Wang
- Department of Rheumatology and Autoimmunology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Shandong Key Laboratory of Rheumatic Disease and Translational Medicine, Shandong Medicine and Health Key Laboratory of Rheumatism, Jinan, Shandong, 250014, People's Republic of China.
| | - Xinyu Liu
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China.
| | - Lianlei Wang
- Department of Orthopaedic Surgery, Qilu Hospital of Shandong University, Jinan, Shandong, 250012, People's Republic of China.
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Ruan DD, Wang RL, Hu YN, Lin X, Luo JW, Yu QH, Wu JB. Clinical and imaging features of six Han patients with SAPHO syndrome. Acta Radiol 2024; 65:211-224. [PMID: 36503262 DOI: 10.1177/02841851221142783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoimmune disease characterized by skin or osteoarticular damage. SAPHO syndrome is often misdiagnosed or missed diagnosis due to lack of overall understanding of the disease by clinicians. PURPOSE To analyze the clinical symptoms and imaging features of six Han patients with SAPHO syndrome in order to provide reference for doctors to diagnose SAPHO syndrome. MATERIAL AND METHODS This study retrospectively analyzed the clinical data of six Han patients with SAPHO syndrome. RESULTS All six Han patients with SAPHO syndrome had severe acne or pustulosis of the hands and feet, and all of them had osteoarticular damage, including five cases involving the sternoclavicular joint. Some patients showed a specific and typical "bull's head" sign on 99mTc-labeled methylene diphosphonate bone imaging. Among the six patients recruited, there was one thoracic vertebra, one cervical vertebra, one sacroiliac joint, and one peripheral joint involvement. Two patients had limited activity due to severe osteoarticular damage. CONCLUSION Due to the atypical clinical symptoms of SAPHO syndrome, most patients will experience a tortuous and long diagnostic process, while a correct understanding and timely intervention of SAPHO syndrome are essential to improve the prognosis of patients.
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Affiliation(s)
- Dan-Dan Ruan
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
| | - Ruo-Li Wang
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
| | - Ya-Nan Hu
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
| | - Xing Lin
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
- Thoracic Surgery Department, Fujian Provincial Hospital, Fuzhou, PR China
| | - Jie-Wei Luo
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
- Department of Traditional Chinese Medicine, Fujian Provincial Hospital, Fuzhou, PR China
| | - Qing-Hua Yu
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
- Radiology Department, Fujian Provincial Hospital, Fuzhou, PR China
| | - Jia-Bin Wu
- Fujian Provincial Hospital, Shengli Clinical Medical College, Fujian Medical University, Fuzhou, PR China
- Nephrology Department, Fujian Provincial Hospital, Fuzhou, PR China
- Fuzhou Second Hospital of Xiamen University, School of Medicine, Xiamen University, Fuzhou, China
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