腰痛伴不典型皮肤病变的SAPHO综合征1例并文献复习  

SAPHO Syndrome with Low Back Pain and Atypical Skin Lesions:A Case Report and Literature Review

作　　者：奚旺 冯刚 XI Wang;FENG Gang(School of Medicine,Jianghan University,Wuhan 430056,Hubei,China;Department of Oncology,Wuhan Fourth Hospital,Tongji Medical College,Huazhong University of Science and Techonology,Wuhan 430030,Hubei,China)

机构地区：[1]江汉大学医学院,湖北武汉430056 [2]华中科技大学同济医学院附属武汉市第四医院肿瘤科,湖北武汉430030

出　　处：《江汉大学学报（自然科学版）》2022年第2期76-79,共4页Journal of Jianghan University：Natural Science Edition

摘　　要：目的SAPHO综合征为临床上罕见的自身免疫性疾病,掌握该病的临床表现及影像学特征,结合相关文章复习以提高对该疾病的认识及诊断准确性。方法分析收治1例“腰痛”为主要表现合并不典型皮肤改变SAPHO综合征患者,复习相关文献资料,总结临床特征。结果患者以“腰痛伴双下肢疼痛”为主要表现伴不典型皮肤改变。辅助检查红细胞沉降率(ESR)、C反应蛋白(CRP)、补体C3、补体C4升高,抗组蛋白抗体弱阳性;胸部CT示胸肋锁骨肥厚综合征。全身骨扫描(ECT)示双侧锁骨、胸骨骨质代谢异常活跃灶,考虑SAPHO综合征可能。结论SAPHO综合征的临床表现缺乏特异性,其诊断需根据临床表现、既往病史、影像学检查,其中全身骨扫描对该病的诊断具有特异性。Objective SAPHO syndrome is a clinically rare autoimmune disease.Grasp the clinical manifestations and imaging features of the disease,and combine the review of related articles with improving the understanding of the disease and the accuracy of diagnosis.Methods One SAPHO syndrome patient with″low back pain″as the primary manifestation and atypical skin changes was analyzed and treated,combined with the relevant literature review,and the clinical characteristics were summarized.Results The primary manifestation of the patient was″low back pain with pain in both lower limbs″with atypical skin lesions.The check results showed the erythrocyte sedimentation rate,C-reactive protein,complement C3,and complement C4 increased,and the anti-histone antibody is weakly positive.Chest CT showed sternal rib clavicular hypertrophy syndrome.Whole-body bone scan(ECT)showed abnormal active bone metabolism foci on both sides of the clavicle and sternum,considering the possibility of SAPHO syndrome.Conclusion The clinical manifestations of SAPHO syndrome lack specificity,and its diagnosis should be based on clinical manifestations,past medical history,and imaging examinations.The diagnosis of the disease by whole-body bone scan(ECT)is specific.

关 键 词：SAPHO综合征 痤疮 骨炎 滑膜炎 腰痛 不典型性皮肤病变 

分 类 号：R597.9[医药卫生—内科学]