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Li Y, Hou X, Liu S, Lu S, Du M, Dong X, Liu X, Li C. Synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome with cranial bone involvement: Case report and literature review. Int J Rheum Dis 2023; 26:2304-2309. [PMID: 37218535 DOI: 10.1111/1756-185x.14740] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 04/26/2023] [Accepted: 05/05/2023] [Indexed: 05/24/2023]
Abstract
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is a rare autoimmune inflammatory disease characterized by osteoarticular and dermatological manifestations. The most common osteoarticular manifestations involve the anterior chest wall, axial skeleton, and long bones. Cranial bone involvement is less reported in SAPHO syndrome. We herein present three cases of SAPHO syndrome with cranial bone involvement, and review the previous literature on similar manifestations. It was revealed that SAPHO syndrome could lead to cranial bone involvement, which could involve the dura mater, leading to hypertrophic pachymeningitis, but the outcome is usually good. Janus kinase inhibitors may be a potential treatment option.
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Affiliation(s)
- Yuan Li
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiujuan Hou
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Shengyan Liu
- School of Clinical Medicine, Peking Union Medical College, Beijing, China
| | - Siyi Lu
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Mengmeng Du
- School of Clinical Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xia Dong
- Department of Rheumatology, Fangshan Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoping Liu
- Department of Rheumatology, Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Chen Li
- Department of Rheumatology, Fangshan Hospital Beijing University of Chinese Medicine, Beijing, China
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Taniguchi A, Ichikawa Y, Maeda M, Tomimoto H. Chronic recurrent multifocal osteomyelitis mimicking migraine. Pract Neurol 2023; 23:88-90. [PMID: 36717208 PMCID: PMC9933157 DOI: 10.1136/pn-2022-003522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2022] [Indexed: 02/02/2023]
Affiliation(s)
- Akira Taniguchi
- Neurology, Graduate School of Medicine Faculty of Medicine, Mie University, Tsu, Japan
| | - Yasutaka Ichikawa
- Department of Radiology, Graduate School of Medicine Faculty of Medicine, Mie University, Tsu, Mie, Japan
| | - Masayuki Maeda
- Department of Neuroradiology, Graduate School of Medicine Faculty of Medicine, Mie University, Tsu, Mie, Japan
| | - Hidekazu Tomimoto
- Neurology, Graduate School of Medicine Faculty of Medicine, Mie University, Tsu, Japan
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Maranini B, Ciancio G, Rinaldi R, Borrelli M, Pugliatti M, Govoni M. SAPHO Syndrome Presenting With Atlo-Epistrophic Synovitis and Left Vocal Cord Paresis: A Challenging Diagnosis. CLINICAL MEDICINE INSIGHTS: ARTHRITIS AND MUSCULOSKELETAL DISORDERS 2022; 15:11795441221118918. [PMID: 36090594 PMCID: PMC9459495 DOI: 10.1177/11795441221118918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) is a rare
syndrome mainly characterized by cutaneous and osteoarticular
manifestations. The most typical osteoarticular manifestations are
localized to the anterior chest wall and include a usually
noninfectious osteitis, hyperostosis, and synovitis of the
sternoclavicular joints. However, clinical presentation of SAPHO
syndrome can be quite heterogeneous. Several clinical and radiological
features are shared with other well-defined pathological entities, and
clinical signs and symptoms often occur at different timepoints.
Mainly due to this complexity and its rarity, there are currently no
validated diagnostic criteria for SAPHO syndrome. Inflammation of the
soft tissues around the bones and possible nerve compression could
contribute to dysphagia, hypophonia, or obstruction of the airways.
Neurologic manifestations could therefore be part of this multiorgan
involvement. Here, we present a case of SAPHO syndrome with atypical
onset symptoms, characterized by left vocal cord paralysis, acute neck
pain due to osteolytic atlantoepistrophic lesion, and an unusual
cutaneous manifestation, diagnosed as mid-dermal elastolysis. The
latest two, to the best of our knowledge, have been here first
described in a case of SAPHO syndrome.
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Affiliation(s)
- Beatrice Maranini
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Ciancio
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - Rosa Rinaldi
- Pathology Unit, ASST Mantova, Ospedale Carlo Poma, Mantova, Italy
| | - Massimo Borrelli
- Neurororadiology Unit, Department of Radiology, Azienda Ospedaliero-Universitaria Sant’Anna, Ferrara, Italy
| | - Maura Pugliatti
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Marcello Govoni
- Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
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Shiraishi W, Hayashi S, Iwanaga Y, Murai H, Yamamoto A, Kira JI. A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome presenting with hypertrophic pachymeningitis. J Neurol Sci 2014; 349:229-31. [PMID: 25549534 DOI: 10.1016/j.jns.2014.12.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 11/04/2014] [Accepted: 12/15/2014] [Indexed: 10/24/2022]
Abstract
A 43-year-old woman with a 3-year history of headache, fever, and swelling of the forehead, presented to our hospital. A general examination revealed palmar and plantar pustules. Blood analyses showed an elevated white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Brain MRI revealed a partially thickened cranial bone with gadolinium enhancement, and also abnormally enhanced dura mater. Bone scintigraphy showed involvement of the cranial bone and bilateral sternoclavicular joints. Palmar skin biopsy indicated palmoplantar pustulosis. From these results, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome with associated hypertrophic pachymeningitis was diagnosed. After corticosteroid therapy and tonsillectomy, the clinical symptoms and radiological abnormalities were improved. Clinicians should be aware of SAPHO as a potential unusual cause of hypertrophic pachymeningitis.
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Affiliation(s)
- Wataru Shiraishi
- Department of Neurology, JCHO Kyushu Hospital, 8-1 kishinoura, Yahatanishi-ku, Kitakyushu City, Fukuoka 806-8501, Japan; Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Shintaro Hayashi
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Yasutaka Iwanaga
- Department of Neurology, JCHO Kyushu Hospital, 8-1 kishinoura, Yahatanishi-ku, Kitakyushu City, Fukuoka 806-8501, Japan
| | - Hiroyuki Murai
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Akifumi Yamamoto
- Department of Neurology, JCHO Kyushu Hospital, 8-1 kishinoura, Yahatanishi-ku, Kitakyushu City, Fukuoka 806-8501, Japan
| | - Jun-ichi Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
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