Cai Yan, You Qingqing, Jiang Weina, Liu Xuyan, Shao Leping
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.
BMC Nephrol. 2025 Jun 3;26(1):273. doi: 10.1186/s12882-025-04208-x.
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.
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.
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.
Not applicable.
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。
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。
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。
不适用。
