A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome presenting with hypertrophic pachymeningitis

Wataru Shiraishi, Shintaro Hayashi, Yasutaka Iwanaga, Hiroyuki Murai, Akifumi Yamamoto, Jun-Ichi Kira

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

A 43-year-old woman with a 3-year history of headache, fever, and swelling of the forehead, presented to our hospital. A general examination revealed palmar and plantar pustules. Blood analyses showed an elevated white blood cell count, C-reactive protein level, and erythrocyte sedimentation rate. Brain MRI revealed a partially thickened cranial bone with gadolinium enhancement, and also abnormally enhanced dura mater. Bone scintigraphy showed involvement of the cranial bone and bilateral sternoclavicular joints. Palmar skin biopsy indicated palmoplantar pustulosis. From these results, SAPHO (synovitis, acne, pustulosis, hyperostosis and osteitis) syndrome with associated hypertrophic pachymeningitis was diagnosed. After corticosteroid therapy and tonsillectomy, the clinical symptoms and radiological abnormalities were improved. Clinicians should be aware of SAPHO as a potential unusual cause of hypertrophic pachymeningitis.

Original languageEnglish
Pages (from-to)229-231
Number of pages3
JournalJournal of the Neurological Sciences
Volume349
Issue number1-2
DOIs
Publication statusPublished - Feb 15 2015

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Hyperostosis
Osteitis
Synovitis
Acne Vulgaris
Meningitis
Bone and Bones
Sternoclavicular Joint
Dura Mater
Tonsillectomy
Forehead
Blood Sedimentation
Gadolinium
Leukocyte Count
Radionuclide Imaging
C-Reactive Protein
Headache
Adrenal Cortex Hormones
Fever
Biopsy
Skin

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome presenting with hypertrophic pachymeningitis. / Shiraishi, Wataru; Hayashi, Shintaro; Iwanaga, Yasutaka; Murai, Hiroyuki; Yamamoto, Akifumi; Kira, Jun-Ichi.

In: Journal of the Neurological Sciences, Vol. 349, No. 1-2, 15.02.2015, p. 229-231.

Research output: Contribution to journalArticle

Shiraishi, Wataru ; Hayashi, Shintaro ; Iwanaga, Yasutaka ; Murai, Hiroyuki ; Yamamoto, Akifumi ; Kira, Jun-Ichi. / A case of synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome presenting with hypertrophic pachymeningitis. In: Journal of the Neurological Sciences. 2015 ; Vol. 349, No. 1-2. pp. 229-231.
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