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与SAPHO综合征和IgA肾病相关的牙科汞合金:一例报告及文献综述

Dental amalgam associated with SAPHO syndrome and IgA nephropathy: a case report and literature review.

作者信息

Cai Yan, You Qingqing, Jiang Weina, Liu Xuyan, Shao Leping

机构信息

Department of Nephrology, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China.

Department of Pathology, Qingdao Municipal Hospital, University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China.

出版信息

BMC Nephrol. 2025 Jun 3;26(1):273. doi: 10.1186/s12882-025-04208-x.

Abstract

BACKGROUND

Exposure to metals is associated with adverse health effects, including multiorgan damage and dysregulation of systemic immune responses. The increasing use of metallic implants in humans, such as dental materials and orthopedic devices, has resulted in chronic endogenous exposure to metal ions. The pathophysiological mechanisms underlying implant-related complications and their clinical implications have not been fully elucidated.

CASE PRESENTATION

We present a case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome coexisting with IgA nephropathy (IgAN) in the context of dental amalgam exposure. Following amalgam placement, the patient developed palmoplantar pustulosis (PPP) and sternoclavicular arthritis, with a subsequent diagnosis of IgAN. Notably, all the clinical manifestations were markedly resolved after amalgam removal.

CONCLUSION

This case suggests a potential link between SAPHO syndrome, IgAN, and dental amalgam exposure. To our knowledge, this is the first reported case linking these conditions. Further studies are needed to elucidate the mechanisms and clinical implications of metal-induced autoimmune or inflammatory responses.

CLINICAL TRIAL NUMBER

Not applicable.

摘要

背景

接触金属与不良健康影响相关,包括多器官损伤和全身免疫反应失调。金属植入物在人类中的使用日益增加,如牙科材料和骨科器械,导致了对金属离子的慢性内源性接触。植入物相关并发症的病理生理机制及其临床意义尚未完全阐明。

病例报告

我们报告一例在接触牙科汞合金的情况下,滑膜炎、痤疮、脓疱病、骨肥厚和骨炎(SAPHO)综合征与IgA肾病(IgAN)共存的病例。放置汞合金后,患者出现掌跖脓疱病(PPP)和胸锁关节炎,随后被诊断为IgAN。值得注意的是,取出汞合金后,所有临床表现均明显缓解。

结论

该病例提示SAPHO综合征、IgAN和牙科汞合金接触之间可能存在联系。据我们所知,这是首例报道的将这些病症联系起来的病例。需要进一步研究以阐明金属诱导的自身免疫或炎症反应的机制及其临床意义。

临床试验编号

不适用。

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