Journal Article Successful treatment of SAPHO syndrome using alendronate-a case report

SUZUKI, Takane  ,  鈴木, 崇根  ,  KUNIYOSHI, Kazuki  ,  國吉, 一樹  ,  MATSUURA, Yuusuke  ,  松浦, 佑介  ,  KAKIZAKI, Jun  ,  柿崎, 潤  ,  SUKEGAWA, Kouji  ,  助川, 浩士  ,  OGAWA, Yasuhumi  ,  小川, 泰史  ,  KOBAYASHI, Tomoko  ,  小林, 倫子  ,  ABE, Rei  ,  安部, 玲  ,  KIUCHI, Hitoshi  ,  木内, 均  ,  UENO, Keisuke  ,  上野, 啓介  ,  AKASAKA, Tomoyo  ,  赤坂, 朋代  ,  KANAZUKA, Aya  ,  金塚, 彩  ,  TAKAHASHI, Kazuhisa  ,  高橋, 和久

91epp.e29 - e32 , 2015-10-01 , The Chiba Medical Society , 千葉医学会
Syndrome acne pustulose hyperostose osteite (SAPHO) is characterized by synovitis, acne, pustulosis, hyperostosis, and osteitis. Here we report the case of a patient with SAPHO syndrome successfully treated with alendronate. A 34-year-old man presented with a one-year history of recurrent pain at the ulnar side of the right forearm. A roentgenogram and a CT scan revealed the hyperostotic consolidation of the ulna with radiolucent area. Bone scintigram displayed increased uptake at the diaphysis of the ulna, sterno-clavicular joints, and iliosacral joints. Based on these findings, bone curettage was performed. The surgically resected specimen revealed chronic recurrent osteomyelitis, suggesting SAPHO syndrome. We administrated 35 mg of alendronate per week orally. The ulnar pain disappeared for three weeks after this administration. The treatment continued for 13 months, and the patient remained completely pain-free 12 months after the cessation of alendronate. Furthermore, bone scintigrams gradually improved. Alendronate possibly brought initial pain relief through its anti-inflammatory effect and long-term pain relief by suppressing bone remodeling.

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