Synovitis-acne-pustulosis-hyperostosis-osteitis Syndrome with Bilateral Pleural Effusion

Adachi‐Katayama, Maho; Kondo, Yuya; Okamoto, Susumu; Sato, Ryota; Morinaka, Satoshi; Nishiyama, Taihei; Terasaki, Mayu; Terasaki, Toshihiko; Toko, Hirofumi; Yagishita, Mizuki; Takahashi, Hiroyuki; Hagiwara, Shinji; Tsuboi, Hiroto; Sumida, Takayuki; Matsumoto, Isao

doi:10.2169/internalmedicine.8473-21

Cited by 3 publications

(1 citation statement)

References 11 publications

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“…A recent study showed that SAPHO syndrome may cause pulmonary vasculitis, 28 which may be a reason for pulmonary artery stenosis. Moreover, other pulmonary manifestations, such as patchy shadows (32.8%), ground‐glass opacity (16.4%), and pleural thickening (13.4%), were not uncommon in SAPHO patients 29 . The etiology of brain and pulmonary manifestation within SAPHO syndrome is not understood.…”

Section: Extracutaneous/osteoarticular Manifestationsmentioning

confidence: 99%

Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome

Hu,

Liu,

Cui

et al. 2023

Int J of Rheum Dis

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Section: Extracutaneous/osteoarticular Manifestationsmentioning

confidence: 99%

Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome

Hu,

Liu,

Cui

et al. 2023

Int J of Rheum Dis

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A case of synovitis-acne-pustulosis-hyperostosis-osteitis syndrome with right pleural effusion

Kakimoto,

Tamura,

Koyanagi

et al. 2023

Respiratory Medicine Case Reports

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Paediatric SAPHO syndrome with pleural effusion: Case report of a unique finding in a rare disease

Kruger,

Wang,

Grim

2024

Modern Rheumatology Case Reports

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Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome is a rare autoinflammatory disease characterized by bone inflammation and skin manifestations including acne, palmoplantar pustulosis, psoriasis, or hidradenitis suppurativa. SAPHO syndrome is considered on the same spectrum as chronic nonbacterial osteomyelitis/chronic recurrent multifocal osteomyelitis (CNO/CRMO), the former often being the nomenclature in adults and the latter in children. The diagnosis is made on patterns of clinical manifestations and is a diagnosis of exclusion. While skin and bone manifestations are commonly described with SAPHO syndrome, pleural involvement is rare, and few cases have been described in the literature, especially in pediatric patients. Herein we present a 14-year-old female with a past medical history of hidradenitis supprtiva, eczema, psoriasis, and a prior episode of culture-negative osteomyelitis who presented to the emergency room with chief complaints of right sided pain with inspiration and back pain. Exam revealed palmoplantar pustulosis, hidradenitis supprativa, psoriasis, and tenderness of vertebrae. Imaging showed a right sided pleural effusion and multiple sites of osteitis. Laboratory evaluation revealed elevated inflammatory markers, an exudative pleural effusion with neutrophilic predominance, and no evidence of malignancy, infection, or immunodeficiency. The patient was diagnosed with SAPHO syndrome and treated with naproxen, methotrexate, and golimumab with significant improvement including resolution of the pleural effusion. Pediatric SAPHO syndrome is a rare disease that classically causes osteitis and skin manifestations. This case highlights that pleural effusion can be a rare manifestation of pediatric SAPHO syndrome. Patients with suspected SAPHO syndrome with respiratory symptoms should be evaluated for pleural effusion.

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Synovitis-acne-pustulosis-hyperostosis-osteitis Syndrome with Bilateral Pleural Effusion

Cited by 3 publications

References 11 publications

Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome

Extracutaneous/osteoarticular manifestations in patients with SAPHO syndrome

A case of synovitis-acne-pustulosis-hyperostosis-osteitis syndrome with right pleural effusion

Paediatric SAPHO syndrome with pleural effusion: Case report of a unique finding in a rare disease

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