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伴有椎体病理性骨折的SAPHO综合征:一例报告

SAPHO syndrome with pathological fractures of vertebral bodies: a case report.

作者信息

Li Yalong, Liu Guomin, Zhao Yian, Luo Yungang, Lu Tiancheng

机构信息

Department of Orthopedics, the Second Hospital of Jilin University, Changchun, Jilin, 130041, People's Republic of China.

Jilin provincial Changbai mountain medicine anti-tumor engineering center, Jilin, People's Republic of China.

出版信息

BMC Musculoskelet Disord. 2019 Jan 17;20(1):27. doi: 10.1186/s12891-019-2410-x.

Abstract

BACKGROUND

It's difficult to diagnose and treat synovitis-acne-pustulosis-hyperostosis-osteomyelitis (SAPHO) syndrome due to its rare and unknown pathogenesis. There is no effective treatment for SAPHO syndrome and the consequences of empirical treatment are unpredictable. This study reports a case of a young female diagnosed as SAPHO syndrome with pathological fractures of vertebral bodies.

CASE PRESENTATION

A 29-year-old female complained of the right sternoclavicular joint and back pain accompanied limited activities and cutaneous lesions. Laboratory assays revealed abnormal inflammatory factors. Multiple imaging studies illustrated bone lesions and pathological fractures of vertebral bodies. A diagnosis of SAPHO syndrome was made. The patient was treated with Compound Troxerutin and Poreine Cerebroside Injection, non-steroidal anti-inflammatory drugs (NSAIDs), bisphosphonates, corticosteroids and the thoracolumbar brace. The patient was followed up for 6 months and showed improved results.

CONCLUSIONS

The case supports that multiple image inspections and laboratory tests contribute to diagnose SAPHO syndrome, and combination therapies of Compound Troxerutin and Poreine Cerebroside Injection, NSAIDs, bisphosphonates, corticosteroids and the thoracolumbar brace in the treatment of SAPHO syndrome with pathological fractures of vertebral bodies are crucial to regain health.

摘要

背景

滑膜炎-痤疮-脓疱病-骨肥厚-骨髓炎(SAPHO)综合征因其发病罕见且病因不明,诊断和治疗困难。目前尚无针对SAPHO综合征的有效治疗方法,经验性治疗的后果难以预测。本研究报告了一例被诊断为SAPHO综合征并伴有椎体病理性骨折的年轻女性病例。

病例介绍

一名29岁女性主诉右胸锁关节及背部疼痛,活动受限并伴有皮肤病变。实验室检查显示炎症因子异常。多项影像学检查显示椎体有骨病变及病理性骨折。诊断为SAPHO综合征。患者接受了复方曲克芦丁和猪脑提取物注射液、非甾体抗炎药(NSAIDs)、双膦酸盐、皮质类固醇及胸腰椎支具治疗。对患者进行了6个月的随访,结果显示病情有所改善。

结论

该病例支持多项影像学检查和实验室检查有助于诊断SAPHO综合征,复方曲克芦丁和猪脑提取物注射液、NSAIDs、双膦酸盐、皮质类固醇及胸腰椎支具联合治疗对伴有椎体病理性骨折的SAPHO综合征患者恢复健康至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9afd/6337767/0a590ceeddc4/12891_2019_2410_Fig1_HTML.jpg

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