Objectives: to assess basic features and outcome of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. Methods: all patients seen in our Unit between 1990 and 2008 with SAPHO syndrome according to proposed inclusion criteria and with a follow-up of at least 2 years were identified. Results: seventy-one patients (48 women, 23 men) with SAPHO syndrome were identified. Median disease duration at the end of follow-up was 10 years [interquartile range (IQR) 7-15], while median follow-up duration was 11 years (IQR 6-11.5). Six patients were diagnosed with Crohn’s disease. Fourteen patients had never had cutaneous involvement, while eight patients presented more than one skin manifestation. Nine patients (13%) presented a limited (< 6 months) monophasic course of the disease, 25 cases (35%) had a relapsing-remitting course and in the remaining 37 cases (52%) the acute painful phase had a prolonged course lasting more than 6 months. HLA B27 was found in 4% of the cases. Female gender [OR: 7.2 (95% C.I.: 2.2-22.9)] and the presence at onset of anterior chest wall involvement (ACW) [OR: 5.7 (95% C.I.: 1.8-18.1)], peripheral synovitis (p = 0.0036), skin involvement [OR 10.3 (95% C.I.: 3.4-31.1)] and high values of acute phase reactants [OR 7.7 (95% C.I.: 2.7-22)] correlated with a chronic course and involvement of new osteo-articular sites. Conclusions: a chronic course is the more common evolution of SAPHO syndrome. However, female gender, raised ESR and CRP values, ACW involvement, peripheral synovitis and skin involvement at the onset seem to be associated with a chronic course.
Clinical and radiologic evolution of synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome: A single center study of a cohort of 71 subjects
COLINA, Matteo;GOVONI, Marcello;TROTTA, Francesco
2009
Abstract
Objectives: to assess basic features and outcome of SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. Methods: all patients seen in our Unit between 1990 and 2008 with SAPHO syndrome according to proposed inclusion criteria and with a follow-up of at least 2 years were identified. Results: seventy-one patients (48 women, 23 men) with SAPHO syndrome were identified. Median disease duration at the end of follow-up was 10 years [interquartile range (IQR) 7-15], while median follow-up duration was 11 years (IQR 6-11.5). Six patients were diagnosed with Crohn’s disease. Fourteen patients had never had cutaneous involvement, while eight patients presented more than one skin manifestation. Nine patients (13%) presented a limited (< 6 months) monophasic course of the disease, 25 cases (35%) had a relapsing-remitting course and in the remaining 37 cases (52%) the acute painful phase had a prolonged course lasting more than 6 months. HLA B27 was found in 4% of the cases. Female gender [OR: 7.2 (95% C.I.: 2.2-22.9)] and the presence at onset of anterior chest wall involvement (ACW) [OR: 5.7 (95% C.I.: 1.8-18.1)], peripheral synovitis (p = 0.0036), skin involvement [OR 10.3 (95% C.I.: 3.4-31.1)] and high values of acute phase reactants [OR 7.7 (95% C.I.: 2.7-22)] correlated with a chronic course and involvement of new osteo-articular sites. Conclusions: a chronic course is the more common evolution of SAPHO syndrome. However, female gender, raised ESR and CRP values, ACW involvement, peripheral synovitis and skin involvement at the onset seem to be associated with a chronic course.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
