SAPHO syndrome in which certolizumab pegol was effective: A case report

Abstract

A 45-year-old male suffered from persistent swelling and redness, with pain in his left lower leg and ankle. Pathological findings isolated from the ankle joint by arthroscopic synovectomy showed mild synovitis. Initially, this case was diagnosed as chronic mild arthritis and later treated as phlegmon because of the persistent redness and swelling inflammatory findings in his left lower leg. A systemic survey was performed. Based on the findings-such as chronic ankle arthritis with ipsilateral plantar pustulosis, chronic recurrent multifocal osteomyelitis in left distal tibia with magnetic resonance imaging (MRI), calcaneal osteitis with computed tomography, and pathological findings that neither malignant tumor nor infection was detected-this case reached the definitive diagnosis of SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome. The hot spots detected in the bilateral sternoclavicular and costosternal joints with bone scintigraphy and their arthritic change detected by computed tomography also supported the diagnosis of SAPHO syndrome. This case was refractory to nonsteroidal antiinflammatory drugs (NSAIDS); therefore, the TNF inhibitor certolizumab pegol was tried. This agent rapidly improved not only the chief complaints but also the objective symptoms and laboratory findings at most six weeks after its administration.

Clinical characteristics and treatment status of pustulotic arthro‐osteitis: A single‐center study involving 51 cases

“…Other treatments included glucocorticoids, bisphosphonates, antirheumatic drugs, and TNF inhibitors 14 . In one of our previous case reports, we found that the TNF inhibitor certolizumab pegol is effective, which showed significant improvements in skin symptoms, physical findings, and laboratory findings in 6 weeks of treatment 16 …”

“…14 In one of our previous case reports, we found that the TNF inhibitor certolizumab pegol is effective, which showed significant improvements in skin symptoms, physical findings, and laboratory findings in 6 weeks of treatment. 16 In recent years, there has been remarkable progress in the treatment of PPP. The biological.…”

A case of pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA) syndrome successfully treated with combination therapy of corticosteroids, cyclosporine, and colchicine

“…However, further investigation is required. Although recent reports have emphasized the efficacy of biologics that target inflammatory cytokines such as antibodies to interleukin-1β and tumor necrosis factor-α [5,6] , use of these agents remains uncovered by health insurance in Japan, showing unresolved discrepancy in practical use for clinicians. Conversely, several trials of various treatments have been reported, including corticosteroids, immunosuppressant, and antibiotics, and the efficacy of the combination of corticosteroids and immunosuppressants remains equivocal.…”

Autoinflammatory disease, Nakajo-Nishimura syndrome and further perspective

“…In the past, papers have introduced various autoinflammatory diseases [1,2] . Recently, the concept of these diseases has expanded, and intractable psoriasis, severe acne, and similar related diseases are occasionally included in this disease entity [3][4][5][6][7] .…”