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a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"

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(疾患の徴候となる一群の)症徴候,症候群 / (事件・社会的状態などのパターンを示す)徴候形態

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/07 03:59:14」(JST)

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SAPHO syndrome includes a variety of inflammatory bone disorders that may be associated with skin changes. These diseases share some clinical, radiologic, and pathologic characteristics.

An entity initially known as chronic recurrent multifocal osteomyelitis (CRMO) was first described in 1972.^[1] Subsequently, in 1978,^[2] several cases of CRMO were associated with blisters on the palms and soles (palmoplantar pustulosis). Since then, a number of associations between skin conditions and osteoarticular disorders have been reported under a variety of names, including sternocostoclavicular hyperostosis, pustulotic arthro-osteitis, and acne-associated spondyloarthropathy. The term SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) was coined in 1987^{[citation needed]} to represent this spectrum of inflammatory bone disorders that may or may not be associated with dermatologic pathology.

Definition

Synovitis
Acne — commonly involving the face and upper back.
Pustulosis — usually involving the palms of the hands and/or soles of the feet (palmo-plantar pustulosis).
Hyperostosis
Osteitis

Radiologic findings

Anterior chest wall (most common site, 65–90% of patients):^{[citation needed]} Hyperostosis, sclerosis and bone hypertrophy especially involving the sternoclavicular joint, often with a soft tissue component.
Spine (33% of patients):^{[citation needed]} Segmental, usually involving the thoracic spine. The four main presentations include spondylodiscitis, osteosclerosis, paravertebral ossifications, and sacroiliac joint involvement.
Long bones (30% of patients):^{[citation needed]} usually metadiaphyseal and located in the distal femur and proximal tibia. It looks like chronic osteomyelitis but will not have a sequestrum or abscess.
Flat bones (10% of patients):^{[citation needed]} mandible and ilium.

Peripheral arthritis has been reported in 92% of cases of SAPHO as well.^{[citation needed]}

In children, the SAPHO syndrome is most likely to affect the metaphysis of long bones in the legs (tibia, femur, fibula), followed by clavicles and spine.

Treatment

Bisphosphonate therapy has been suggested as a first-line therapeutic option in many case reports and series.^[3]^[4]^[5]

Treatment with tumor necrosis factor alpha antagonists (TNF inhibitors) have been tried in few patients with limited success.^[6] Other drugs that are used in psoriatic arthritis, to which SAPHO syndrome is closely related, have also been used in this condition. They include NSAIDs, corticosteroids, sulfasalazine, methotrexate, ciclosporin and leflunomide.^[7]

Some patients have responded to antibiotics. The rationale for their use is that Propionibacterium acnes, a bacterium known for its role in acne, has been isolated from bone biopsies of SAPHO patients.^[6]^[8]

References

^ Giedion A, Holthusen W, Masel LF, Vischer D (1972). "Subacute and chronic "symmmetrical" osteomyelitis.". Annals of Radiology (15): 329–42.
^ Bjorksten B, Gustavson KH, Eriksson B, et al. (1978). "Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris". Journal of Pediatrics (93): 227–31.
^ Ichikawa J, Sato E, Haro H, Ando T, Maekawa S, Hamada Y (November 2008). "Successful treatment of SAPHO syndrome with an oral bisphosphonate". Rheumatol. Int. 29 (6): 713–5. doi:10.1007/s00296-008-0760-z. PMID 18998139.
^ Kerrison C, Davidson JE, Cleary AG, Beresford MW (October 2004). "Pamidronate in the treatment of childhood SAPHO syndrome". Rheumatology (Oxford) 43 (10): 1246–51. doi:10.1093/rheumatology/keh295. PMID 15238641.
^ Amital H, Applbaum YH, Aamar S, Daniel N, Rubinow A (May 2004). "SAPHO syndrome treated with pamidronate: an open-label study of 10 patients". Rheumatology (Oxford) 43 (5): 658–61. doi:10.1093/rheumatology/keh149. PMID 14983108.
^ ^a ^b Olivieri I, Padula A, Palazzi C (October 2006). "Pharmacological management of SAPHO syndrome". Expert Opin Investig Drugs 15 (10): 1229–33. doi:10.1517/13543784.15.10.1229. PMID 16989598.
^ Scarpato S, Tirri E (2005). "Successful treatment of SAPHO syndrome with leflunomide. Report of two cases". Clin. Exp. Rheumatol. 23 (5): 731. PMID 16173265.
^ Colina M, Lo Monaco A, Khodeir M, Trotta F (2007). "Propionibacterium acnes and SAPHO syndrome: a case report and literature review". Clin. Exp. Rheumatol. 25 (3): 457–60. PMID 17631745.

SAPHO Syndrome by Mike Chang, M.D., University of Washington Department of Radiology
Earwaker JW, Cotten A (June 2003). "SAPHO: syndrome or concept? Imaging findings". Skeletal Radiol. 32 (6): 311–27. doi:10.1007/s00256-003-0629-x. PMID 12719925.
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UpToDate Contents

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1. 好中球性皮膚症 neutrophilic dermatoses
2. 成人における筋骨格系の胸痛の主な原因 major causes of musculoskeletal chest pain in adults
3. 筋骨格系の胸痛の治療 treatment of musculoskeletal chest pain
4. 掌蹠膿疱症：疫学、臨床的特徴、および診断 palmoplantar pustulosis epidemiology clinical features and diagnosis
5. 尋常性ざ瘡の病因、臨床症状、および診断 pathogenesis clinical manifestations and diagnosis of acne vulgaris

English Journal

SAPHO Syndrome and collagenous colitis.

Wendling D, Verhoeven F, Vuitton L, Guillot X, Prati C.SourceService de rhumatologie, université de Franche-Comté, CHU de Besançon, boulevard Fleming, 25030 Besançon, France. Electronic address: dwendling@chu-besancon.fr.
Joint, bone, spine : revue du rhumatisme.Joint Bone Spine.2012 Nov 6. pii: S1297-319X(12)00225-4. doi: 10.1016/j.jbspin.2012.09.020. [Epub ahead of print]
PMID 23141715

An overview of interleukin-1 receptor antagonist, anakinra, in the treatment of cutaneous diseases.

Pazyar N, Feily A, Yaghoobi R.SourceDepartment of Dermatology, Jahrom University of Medical Sciences, Motahari Street, Honari Clinic, Jahrom, Iran. Dr.feily@yahoo.com.
Current clinical pharmacology.Curr Clin Pharmacol.2012 Nov 1;7(4):271-5.
Interleukin (IL)-1 is a pivotal proinflammatory cytokine consisting of two molecular species, IL-1α and IL-1β. Anakinra (Kineret), a recombinant human IL-1 receptor antagonist, is regarded as a biological agent which blocks the inflammatory effects of IL-1. The aim of this review was to search the
PMID 22794157