Refractory SAPHO syndrome treated successfully with Etanercept
의약학 > 내과학
( Ye Ji Kim ) , ( Sung Jae Choi )
대한내과학회 추계학술발표논문집 2011년, 제2011권 제1호, 335(총1페이지)
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    SAPHO syndrome, which has different skin change and osteoarticular inflammation, is an acronym that stands for synovitis, acne, pustulosis, hyperostosis and osteitis. We report a case with refractory SAPHO syndrome, which was successfully treated with TNF-α blocker. A 28 year-old man came to our hospital for evaluation of right hip joint pain. His hip pain had started 1 year ago. On physical examination, the patient has pain, tenderness on his right hip joint. Acne was seen in his face and scalp. HLA-B27 was negative. Pelvis MRI showed both side sacroilitis. Technetium-99m bone scan revealed increased uptake in both sternocleidoclavicular area and left medial tibial condyle. Biopsy of skin lesion showed acute suppurative inflammation, compatible with acne vulgaris. He was diagnosed with SAPHO syndrome. He was treated with NSAIDs and oral prednisolone, and methotrexate, sulfasalazine, and pamidronate. Despite adequate treatment during 3 weeks, right sacroiliac joint pain continued to demonstrate waxing-and-waning course. In the light of the refractory SAPHO syndrome, treatment with subcutaneous etanacept at doses of 25 mg twice a week was started. After 1 week the treatment, he had improved arthritic symptoms. Treatment was generally well tolerated in our case, with no serious adverse event. This case demonstrates that TNF- α blockers seem to represent an effective therapeutic option in refractory SAPHO syndrome. It is rare case of TNF- α blocker treated refractory SAPHO syndrome in Korea, so we report this case.
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