関: SAPHO syndrome

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locate (a moving entity) by means of a tracking system such as radar
win something through ones efforts; "I acquired a passing knowledge of Chinese"; "Gain an understanding of international finance" (同)win, gain
a pattern of symptoms indicative of some disease
a complex of concurrent things; "every word has a syndrome of meanings"
gotten through environmental forces; "acquired characteristics (such as a suntan or a broken nose) cannot be passed on"

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(不断の努力・習慣などで)…'を'『習得する』,身につける / 〈財産・権利など〉'を'手に入れる,取得する
(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）』「2013/03/19 02:42:16」(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^{[citation needed]}. Subsequently, in 1978^{[citation needed]}, 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 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.^[1]^[2]^[3]

Treatment with tumor necrosis factor alpha antagonists (TNF inhibitors) have been tried in few patients with limited success.^[4] Other drugs which 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.^[5]

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.^[4]^[6]

References

^ 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. http://www.clinexprheumatol.org/pubmed/find-pii.asp?pii=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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[Hands cutaneous exam].

Lorette G1, Samimi M.Author information 1UMR 1352, université François-Rabelais, INRA, infectiologie et santé publique, CHRU de Tours, service de dermatologie, 37044 Tours cedex, France. Electronic address: lorette@med.univ-tours.fr.AbstractThere are four different areas to consider: palms, back of the hands, fingers, periungual folds (and nails). Palmoplantar keratodermas are a group of inherited or acquired disorders. Dysidrosis is a peculiar form of eczema on the palms and lateral aspects of the fingers. SAPHO syndrome (Synovitis - Acne - Pustulosis - Hyperostosis - Osteomyelitis) presents pustules on palms. Photo-ageing is frequently noticed on the back of the hands. Paraneoplastic acrokeratosis (Bazex syndrome) affects the nose, ears, and periungual folds of fingers and toes. Spontaneous blue finger syndrome can be a benign process that resolves rapidly.
Presse médicale (Paris, France : 1983).Presse Med.2013 Dec;42(12):1582-95. doi: 10.1016/j.lpm.2013.06.016. Epub 2013 Oct 21.
There are four different areas to consider: palms, back of the hands, fingers, periungual folds (and nails). Palmoplantar keratodermas are a group of inherited or acquired disorders. Dysidrosis is a peculiar form of eczema on the palms and lateral aspects of the fingers. SAPHO syndrome (Synovitis -
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Systematic review of the efficacy and adverse events associated with infliximab treatment of hidradenitis suppurativa in patients with coexistent inflammatory diseases.

Machet L1, Samimi M, Delage M, Paintaud G, Maruani A.
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Autoinflammatory bone disorders: update on immunologic abnormalities and clues about possible triggers.

Sharma M1, Ferguson PJ.Author information 1Divisions of Rheumatology in Internal Medicine and Pediatrics, University of Iowa, Iowa City, Iowa 52240, USA.AbstractPURPOSE OF REVIEW: To provide an update on the genetics and immunologic basis of autoinflammatory bone disorders including chronic recurrent multifocal osteomyelitis including the monogenic forms of the disease.
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PURPOSE OF REVIEW: To provide an update on the genetics and immunologic basis of autoinflammatory bone disorders including chronic recurrent multifocal osteomyelitis including the monogenic forms of the disease.RECENT FINDINGS: Ongoing research in murine, canine and human models of sterile bone infl
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