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Li L, Du M, Xu H, Hou X, Li C. SAPHO syndrome complicated by multiple venous thrombosis of left lower limb: A case report and literature review. Int J Rheum Dis 2024; 27:e14880. [PMID: 37694521 DOI: 10.1111/1756-185x.14880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 07/28/2023] [Accepted: 08/05/2023] [Indexed: 09/12/2023]
Abstract
Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome is an uncommon clinical syndrome with the signs of skin problems and osteoarthropathy as its main features. The pathogenesis of SAPHO syndrome has not been fully elucidated, and multiple complications may be present, including thrombosis. A 39-year-old male patient was diagnosed with SAPHO syndrome, complicated by multiple venous thrombosis of the left lower limb. We conducted a brief review of the current available literature on thrombosis in patients with SAPHO syndrome and speculated that the presence of lower extremity thrombosis in this patient with SAPHO syndrome may be related to physiological structure or antiphospholipid syndrome. Whether positive lupus anticoagulant has an effect on thrombosis in patients with SAPHO syndrome remains to be investigated.
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Affiliation(s)
- Leqing Li
- Beijing University of Chinese Medicine, Beijing, China
| | - Mengmeng Du
- Beijing University of Chinese Medicine, Beijing, China
| | - Heng Xu
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiujuan Hou
- 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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Chen W, Ito T, Lin S, Song Z, Al‐Khuzaei S, Jurik A, Plewig G. Does
SAPHO
syndrome exist in dermatology? J Eur Acad Dermatol Venereol 2022; 36:1501-1506. [DOI: 10.1111/jdv.18172] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 04/05/2022] [Indexed: 11/30/2022]
Affiliation(s)
- W. Chen
- Department of Dermatology and Allergy Technical University of Munich Munich Germany
| | - T. Ito
- Department of Dermatology Hamamatsu University School of Medicine Hamamatsu Japan
| | - S.‐H. Lin
- Department of Dermatology, Chang Gung Memorial Hospital Kaohsiung Medical Center Kaohsiung Taiwan
| | - Z. Song
- Department of Dermatology and Venereology, Southwest Hospital, Army Medical Universtiy Chongqing China
| | - S. Al‐Khuzaei
- Department of Dermatology, Rumailah Hospital, Hamad Medical Cooperation, Al Rumaila, Off Al Istiolal Street, P.O. Box 3050 Doha Qatar
| | - A.G. Jurik
- Department of Radiology Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University Aarhus Denmark
| | - G. Plewig
- Department of Dermatology and Allergy, Ludwig‐Maximilian‐University of Munich Munich Germany
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Godot A, Fakih O, Prati C, Wendling D, Verhoeven F. SAPHO syndrome and subclavian thrombosis: Simple fortuitous association? Eur J Intern Med 2020; 72:103-105. [PMID: 31796244 DOI: 10.1016/j.ejim.2019.11.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/23/2019] [Accepted: 11/26/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Amélie Godot
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France
| | - Olivier Fakih
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France
| | - Clément Prati
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA 4267 "PEPITE", University of Bourgogne Franche-Comté, 25000 Besancon, France
| | - Daniel Wendling
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA4266 "EPILAB" University of Bourgogne Franche-Comté, 25000 Besancon, France
| | - Frank Verhoeven
- Rheumatology Department, CHRU de BESANCON, 25000 Besancon, France; EA 4267 "PEPITE", University of Bourgogne Franche-Comté, 25000 Besancon, France.
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Cardiovascular disease in patients with autoinflammatory syndromes. Rheumatol Int 2017; 38:37-50. [DOI: 10.1007/s00296-017-3854-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 10/13/2017] [Indexed: 12/16/2022]
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Zimmermann P, Curtis N. Synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome - A challenging diagnosis not to be missed. J Infect 2016; 72 Suppl:S106-14. [PMID: 27263075 DOI: 10.1016/j.jinf.2016.04.030] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
SAPHO syndrome manifests as chronic inflammation of bones and joints, which may or may not be accompanied by skin changes. The term SAPHO is an acronym that stands for synovitis, acne, pustulosis (usually palmoplantar), hyperostosis and osteitis. The bones most commonly affected are those in the anterior chest wall (mainly the sternum, clavicles and sternocostoclavicular joints), the vertebrae and the sacroiliac joints, but peripheral and flat bones may also be involved, especially in children. There are no validated diagnostic criteria for SAPHO, and diagnosis is based on clinical and radiological findings. One of the main challenges in diagnosis is that the clinical features may occur many years apart. Additionally, patients may not develop all manifestations. Delayed diagnosis, as a result of a lack of awareness of SAPHO, can lead to patients suffering ongoing pain and disfiguring skin manifestations. One theory is that Propionibacterium acnes (isolated from bone biopsies in many SAPHO patients) triggers an auto-immune mediated chronic inflammation in genetically predisposed individuals. Treatment involves the use of nonsteroidal anti-inflammatory drugs, intra-articular steroids, bisphosphonates and biologicals. The course of SAPHO is often prolonged but, despite the challenges in diagnosis and treatment, the long-term prognosis is good.
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Affiliation(s)
- Petra Zimmermann
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia
| | - Nigel Curtis
- Infectious Diseases Unit, The Royal Children's Hospital Melbourne, Parkville, Australia; Department of Paediatrics, The University of Melbourne, Parkville, Australia; Infectious Diseases & Microbiology Research Group, Murdoch Children's Research Institute, Parkville, Australia.
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Ishizuka M, Yamamoto Y, Yamada S, Maemura S, Nakata R, Motozawa Y, Yamamoto K, Takizawa M, Uozumi H, Ikenouchi H. Bilateral Subclavian Vein Occlusion in a SAPHO Syndrome Patient Who Needed an Implantable Cardioverter Defibrillator. Int Heart J 2016; 57:380-2. [PMID: 27181039 DOI: 10.1536/ihj.15-453] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A 79-year-old Asian man was hospitalized because of progressive exertional dyspnea with decreasing left ventricular ejection fraction and frequent non-sustained ventricular tachycardia. Pre-procedure venography for implantable cardioverter defibrillator (ICD) implantation showed occlusion of the bilateral subclavian veins. In consideration of subcutaneous humps in the sterno-clavicular area and palmoplantar pustulosis, we diagnosed him as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome and speculated that it induced peri-osteal chronic inflammation in the sterno-clavicular area, resulting in occlusion of the adjacent bilateral subclavian veins. An automatic external defibrillator (AED) was installed in the patient's house and total subcutaneous ICD was considered. Venous thrombosis in SAPHO syndrome is not frequent but has been reported. To the best of our knowledge, this is the first case of bilateral subclavian vein occlusion in a SAPHO syndrome patient who needs ICD implantation.
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Carranco-Medina TE, Hidalgo-Calleja C, Calero-Paniagua I, Sánchez-González MD, Quesada-Moreno A, Usategui-Martín R, Pérez-Garrido L, Gómez-Castro S, Montilla-Morales CA, Martínez-González O, del Pino-Montes J. Manifestaciones trombóticas en el síndrome SAPHO. Revisión de la literatura. ACTA ACUST UNITED AC 2015; 11:108-11. [DOI: 10.1016/j.reuma.2014.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 07/09/2014] [Accepted: 07/09/2014] [Indexed: 10/24/2022]
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Carranco-Medina TE, Hidalgo-Calleja C, Calero-Paniagua I, Sánchez-González MD, Quesada-Moreno A, Usategui-Martín R, Pérez-Garrido L, Gómez-Castro S, Montilla-Morales CA, Martínez-González O, del Pino-Montes J. Thrombotic Manifestations in SAPHO Syndrome. Review of the Literature. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.reumae.2014.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sanges S, Ducoulombier V, Sivery B, Delhaye N, Haffner C, Houvenagel E. Thrombosis of the left subclavian vein complicating SAPHO syndrome: A case report. Joint Bone Spine 2014; 81:460-1. [DOI: 10.1016/j.jbspin.2014.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2014] [Indexed: 11/29/2022]
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Abstract
SAPHO syndrome is a disorder characterized by Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis. As the osteoarticular and skin manifestations often do not occur simultaneously and there are no validated diagnostic criteria, the diagnosis can be difficult. Clinical and imaging investigation is necessary to establish the many differential diagnoses of SAPHO syndrome. The etiopathogenesis involves infectious (probably Propionibacterium acnes), immunologic, and genetic factors. Treatment is based on information gathered from case reports and small series, and is related to specific skin or articular symptoms.
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Affiliation(s)
- Sueli Carneiro
- State University of Rio de Janeiro - Rua Farme de Amoedo 140/601, Ipanema, Rio de Janeiro 22420-020, Brazil
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Coloe J, Diamantis S, Henderson F, Morrell DS. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome complicated by seven pulmonary emboli in a 15-year old patient. J Am Acad Dermatol 2010; 62:333-6. [PMID: 20115954 DOI: 10.1016/j.jaad.2009.02.049] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2008] [Revised: 12/07/2008] [Accepted: 02/02/2009] [Indexed: 10/20/2022]
Abstract
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome represents a spectrum of various dermatologic and musculoskeletal conditions. Thromboses have infrequently been reported in SAPHO syndrome, most often in the subclavian vein. There have been no reported cases of pulmonary emboli associated with SAPHO. We report a case of a young patient with SAPHO syndrome who later presented with extensive iliofemoral deep vein thromboses and seven pulmonary emboli.
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Le Jeune S, Pistorius MA, Planchon B, Pottier P. [Risk of venous thromboembolism in acute medical illnesses. Part 2: Situations at risk in ambulatory, hospital and internal medicine settings]. Rev Med Interne 2008; 29:462-75. [PMID: 18400339 DOI: 10.1016/j.revmed.2008.01.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 01/27/2008] [Accepted: 01/31/2008] [Indexed: 01/18/2023]
Abstract
PURPOSE The increased risk of thromboembolism in acute medical illnesses (AMI) is difficult to assess because of the diversity of medical conditions. The first part of this review of the literature was dedicated to methods of risk analysis based on our current pathophysiological knowledge. This second part describes more specifically the risk of venous thrombosis linked to AMI in hospital, ambulatory and internal medicine settings. CURRENT KNOWLEDGE AND KEY POINTS The incidence of venous thromboembolism is higher in hospital than in ambulatory setting, albeit the latter remains significant. Stroke and affections leading to intensive care management represent conditions at great risk. Several mechanisms leading to a prothrombotic state have been identified, explaining the increased risk observed during relapses of pathologies specifically treated in internal medicine such as lupus erythematosus, Wegener granulomatosis, inflammatory bowel diseases and Behcet's disease. FUTURE PROSPECTS AND PROJECTS Next to the pathophysiological understanding of venous thrombosis, the assessment of the specific thrombogenic burden of an AMI is an additive tool to screen medical patients at high risk. This systematic review of the literature shows uncertainties towards some risk factors as bedrest or acute inflammatory response. Taking into account the methodological difficulties inherent to prospective and epidemiological studies, a meta-analysis focusing on these factors would be useful to refine prevention guidelines for venous thromboembolism in medical setting.
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Affiliation(s)
- S Le Jeune
- Service de médecine interne, CHU Hôtel-Dieu, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France.
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Lachman RS. S. TAYBI AND LACHMAN'S RADIOLOGY OF SYNDROMES, METABOLIC DISORDERS AND SKELETAL DYSPLASIAS 2007. [PMCID: PMC7315357 DOI: 10.1016/b978-0-323-01931-6.50027-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ozyemisci-Taskiran O, Bölükbasi N, Gögüs F. A hidradenitis suppurativa related SAPHO case associated with features resembling spondylarthropathy and proteinuria. Clin Rheumatol 2006; 26:789-91. [PMID: 16680392 DOI: 10.1007/s10067-005-0199-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2005] [Accepted: 05/21/2005] [Indexed: 10/24/2022]
Abstract
We present a 53-year-old man with synovitis-acne-palmoplantar pustulosis-hyperosteosis-osteitis (SAPHO) syndrome who is HLA-B27 positive with a history of uveitis and complicated by proteinuria and osteoporosis. Interesting, yet unreported features of SAPHO syndrome and the etiology of proteinuria are further discussed.
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Affiliation(s)
- Ozden Ozyemisci-Taskiran
- Physical Medicine and Rehabilitation, Gazi University, 9. Sokak 27/6, Besevler, 06490 Ankara, Turkey.
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