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The evolving clinical picture of seronegative spondyloarthropathy based on the example of ankylosing spondylitis in a patient with a primary diagnosis of the SAPHO syndrome — case presentation
Affiliations- Świętokrzyskie Centrum Reumatologii, ul. Gimnazjalna 41 B, 26-200 Końskie, Poland
- Department of Rheumatology and Connective Tissue Diseases, Collegium Medicum,, ul. Ujejskiego 75, 85-168 Bydgoszcz, Poland
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Abstract
Seronegative spondyloarthropathies are a group of diseases characterized by several clinical features such as inflammatory back pain, sacroiliac joint inflammation, and the presence of the HLA B27 antigen, which occurs more frequently than the general population. Non-specific bowel inflammation, skin lesions, particularly psoriasis or uveitis, are also typical in patients or their family members [1]. In many situations, clinical progression of spondyloarthropathies can be assessed by imaging of the sacroiliac joints [2, 3]. SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis), is a rare disease, classified as seronegative spondyloarthropathy due to many typical clinical features for this group of diseases. A large variety of symptoms and atypical clinical picture of SAPHO syndrome causes significant diagnostic difficulties [3, 4]. Presented here is a case report of a 41-year-old male patient with a twenty-year history of the disease. Initially, his disease took the form of chronic, recurrent multifocal osteomyelitis (CRMO), which finally turned into a spondyloarthropathy that met the classification criteria for ankylosing spondylitis.
Abstract
Seronegative spondyloarthropathies are a group of diseases characterized by several clinical features such as inflammatory back pain, sacroiliac joint inflammation, and the presence of the HLA B27 antigen, which occurs more frequently than the general population. Non-specific bowel inflammation, skin lesions, particularly psoriasis or uveitis, are also typical in patients or their family members [1]. In many situations, clinical progression of spondyloarthropathies can be assessed by imaging of the sacroiliac joints [2, 3]. SAPHO syndrome (Synovitis, Acne, Pustulosis, Hyperostosis, Osteitis), is a rare disease, classified as seronegative spondyloarthropathy due to many typical clinical features for this group of diseases. A large variety of symptoms and atypical clinical picture of SAPHO syndrome causes significant diagnostic difficulties [3, 4]. Presented here is a case report of a 41-year-old male patient with a twenty-year history of the disease. Initially, his disease took the form of chronic, recurrent multifocal osteomyelitis (CRMO), which finally turned into a spondyloarthropathy that met the classification criteria for ankylosing spondylitis.
Keywords
seronegative spondyloarthropathy, ankylosing spondylitis, SAPHO syndrome, osteomyelitis, CRMO, spondylodiscitis
About this articleTitle
The evolving clinical picture of seronegative spondyloarthropathy based on the example of ankylosing spondylitis in a patient with a primary diagnosis of the SAPHO syndrome — case presentation
Journal
Issue
Article type
Case report
Pages
221-226
Published online
2018-12-18
Page views
1253
Article views/downloads
1080
DOI
Bibliographic record
Medical Research Journal 2018;3(4):221-226.
Keywords
seronegative spondyloarthropathy
ankylosing spondylitis
SAPHO syndrome
osteomyelitis
CRMO
spondylodiscitis
Authors
Zbigniew Paweł Guzera
Tomasz Koasakowski
Sławomir Jeka
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