Implication of bisphosphonate use in the treatment of SAPHO syndrome: Case report and discussion of current literature

Journal of Medical Hypotheses and Ideas Pub Date : 2015-12-01 DOI:10.1016/j.jmhi.2015.04.002

Patricia Gorecki , Philipp Stockmann , Jörg H.W. Distler , Wolfgang Wuest , Daniela Schmidt , Friedrich Wilhelm Neukam , Emeka Nkenke , Falk Wehrhan

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引用次数: 7

Abstract

Even though increasing knowledge is emerging about synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome its pathogenesis remains enigmatic. Women are preferentially affected by SAPHO syndrome. Here we present the case of a 39-year-old woman suffering from this syndrome whose bone involvement was first interpreted as diffuse sclerosing osteomyelitis of the mandible. As treatment with clindamycin did not improve the symptoms, the decision was made to administer bisphosphonates intravenously. This treatment led to a rapid improvement in symptoms, which could be explained by the apparent tendency of bisphosphonates to exert a positive effect on the jaw. With this case report we attempt to offer an explanation for the influence of this group of medications on patients suffering from SAPHO syndrome with mandibular involvement.

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使用双膦酸盐治疗SAPHO综合征的意义:病例报告和当前文献的讨论

尽管关于滑膜炎、痤疮、脓疱病、骨质增生和骨炎(SAPHO)综合征的知识越来越多，但其发病机制仍然是一个谜。女性更容易患SAPHO综合征。在这里，我们提出的情况下，39岁的妇女患有这种综合征，其骨累及首先解释为弥漫性硬化性骨髓炎下颌骨。由于用克林霉素治疗并没有改善症状，因此决定静脉注射双膦酸盐。这种治疗导致症状的迅速改善，这可以用双磷酸盐对颌骨产生积极作用的明显趋势来解释。在这个病例报告中，我们试图解释这组药物对患有SAPHO综合征的患者下颌受累的影响。

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