SAPHO-Syndrom

Zusammenfassung

Das SAPHO-Syndrom ist eine Erkrankung, die besondere Herausforderungen an die Differenzialdiagnose durch Rheumatologen und Radiologen stellt. Von anderen entzündlich rheumatischen Erkrankungen unterscheidet sich das SAPHO-Syndrom durch den überwiegenden Befall des Knochens in Form einer Osteitis, während die Arthritis oft eher im Hintergrund steht. Das SAPHO-Syndrom kommt häufig, aber nicht immer, in Assoziation mit der charakteristischen Hauterscheinung der palmaroplantaren Pustulosa-Form der Psoriasis vor, und die nosologische Einteilung dieses Syndroms bereitet immer noch Schwierigkeiten. Der gehäufte Nachweis von Propionibacterium acne, wie auch das zumindest passagere Ansprechen vieler Patienten auf das Antibiotikum Azithromycin, macht eine bakterielle Genese der Erkrankung möglich. In neuerer Zeit wurden mit Erfolg Biologika, vor allem TNF-Inhibitoren, eingesetzt, die in Fallsammlungen in einer großen Anzahl der Patienten ein Ansprechen induzieren konnten.

Summary

SAPHO-syndrome is a disease which has specific challenges for differential diagnosis by rheumatologists and radiologists. In contrast to other inflammatory rheumatic diseases the SAPHO syndrome mainly involves the bone as it induces osteitis, while arthritis of the joints is not regularly found. The SAPHO syndrome often associates with the typical skin manifestation of palmaro-plantaris pustulosa and the nosological classification of the syndrome still is not clear. The frequent detection of Propionibacterium acne and the, although transitory, response to the antibiotic azithromycine makes a bacterial genesis of the disease possible. Currently biologic drugs, in particular TNF-inhibitors, were successfully used in case studies in which in large numbers of the patients a response could be induced.

Schlüsselwörter

SAPHO-Syndrom - Osteitis - Spondylitis - TNF-Inhibitoren - Antibiotika - Bisphosphonate

Keywords

SAPHO-Syndrome - osteitis - spondylitis - TNF-Inhibitors - antibiotics - bisphosphonates

• Literatur

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