Skip to main content

Advertisement

SpringerLink
Log in

Is SAPHO syndrome a target for antibiotic therapy?

  • Case Report
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The etiology of the synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome remains unclear. Infectious factors are proposed to be relevant in the etiopathogenesis of the disease. To our knowledge, this is the first reported case of a proposed relationship between Staphylococcus aureus cultured from plantar pustule and SAPHO syndrome, which was successfully treated with co-trimoxazole (CTM) (sulfamethoxazole/trimetoprim). CTM might be the drug of choice for therapy for SAPHO syndrome because of combined antibiotic and immunomodulatory properties. Hypersensitivity testing of the medication in vitro was performed to identify, in the preclinical stage, the hypersensitivity reaction to CTM, which may have been severe.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

References

  1. Chamot AM, Vion B, Gerster JC (1986) Acute pseudoseptic arthritis and palmoplantar pustulosis. Clin Rheumatol 5:118–123

    Article  PubMed  CAS  Google Scholar 

  2. Chamot AM, Benhamou CL, Kahn MF, Beraneck L, Kaplan G, Prost A (1987) Acne-pustulosis-hyperostosis-osteitis syndrome. Results of a national survey, 85 cases. Rev Rhum Mal Osteoartic 54:187–196

    PubMed  CAS  Google Scholar 

  3. Giedion A, Holthusen W, Masel LF, Vischer D (1972) Subacute and chronic “symmetrical” osteomyelitis. Ann Radiol (Paris) 15:329–342

    CAS  Google Scholar 

  4. Boutin RD, Resnick D (1998) The SAPHO syndrome: an evolving concept for unifying several idiopathic disorders of bone and skin. AJR Am J Roentgenol 170:585–591

    PubMed  CAS  Google Scholar 

  5. Edlund E, Johnson U, Lidgren E et al (1988) Palmoplantar pustulosis and sternoclavicular arthroosteitis. Ann Rheum Dis 47:809–815

    Article  PubMed  CAS  Google Scholar 

  6. Pillon P, Pajon A, Juvin R, Gaudin P, Tourne Y, Pasquier V et al (1992) Tibial hyperostopsis and propiobactgerium acnes. Rev Rhum Mal Osteoartic 59:349–351

    PubMed  CAS  Google Scholar 

  7. Wagner AD, Mai U, Hammer M, Zeidler H (1997) Long term antibiotic therapy successful in patients with SAPHO syndrome. Arthritis Rheum 40(Suppl 9):S62

    Google Scholar 

  8. Taurog JD, Richardson JA, Croft JT et al (1994) The germ-free state prevents development of gut and joint inflammatory disease in HLA-B27 transgenic rats. J Exp Med 180:2359–2364

    Article  PubMed  CAS  Google Scholar 

  9. Khare SD, Luthra HS, Davis CS (1995) Spontaneous inflammatory arthritis in HLA-B27 transgenic mice lacking beta 2-microglobulin: a model of human spondyloarthropathies. J Exp Med 182:1153–1158

    Article  PubMed  CAS  Google Scholar 

  10. Klinman D (2003) Does activation of the innate immune system contribute to the development of rheumatoid arthritis? Arthritis Rheum 48:590–593

    Article  PubMed  Google Scholar 

  11. Trimble BS, Evers CJ, Ballaron SA, Young JM (1987) Intraarticular injection of Propionebacterium acnes causes an erosive arthritis in rats. Agents Actions 21:281–283

    Article  PubMed  CAS  Google Scholar 

  12. Hayem G, Bouchaud-Cabot A, Benali K, Roux S, Palazzo E (1999) SAPHO syndrome: a long-term follow-up study of 120 cases. Semin Arthritis Rheum 29:159–171

    Article  PubMed  CAS  Google Scholar 

  13. Rozin A (2005) Is Behcet’s syndrome associated with infection? Ann Rheum Dis 64:513–514

    Article  PubMed  CAS  Google Scholar 

  14. Carter J, Valeriano J, Vasey F (2004) Doxycycline versus doxycycline plus rifampycin in undifferentiated spondyloarthropathy, with special reference to chlamydia-induced arthritis. J Rheumatol 31:1973–1980

    PubMed  CAS  Google Scholar 

  15. De Remee RA, McDonald TJ, Weiland LH (1985) Wegener's granulomatosis: observations on treatment with antimicrobial agents. Mayo Clin Proc 60:27–32

    PubMed  CAS  Google Scholar 

  16. Rozin AP, Schapira D, Bergman R (2003) Alopecia areata and relapsing polychondritis or mosaic of autoimmunity? The first experience of cotrimoxazole treatment. Ann Rheum Dis 62:778–780

    Article  PubMed  CAS  Google Scholar 

  17. Amital H, Applbaum YH, Aamar S, Daniel N, Rubinow A (2004) SAPHO syndrome treated with pamidronate: an open-label study of 10 patients. Rheumatology 43:658–661

    Article  PubMed  CAS  Google Scholar 

  18. Whyte MP, Wenkeri D, Clements KL, McAlister WH, Mumm S (2003) Bisphosphonate-induced osteopetrosis. N Engl J Med 349:457–463

    Article  PubMed  CAS  Google Scholar 

  19. Munier A, Gras V, Andrejak M, Bernard N, Jean-Pastor MJ, Gautier S, Biour M, Massy Z (2005) Zoledronic acid and renal toxicity: data from French adverse effect reporting database. Ann Pharmacother 39:1194–1197

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The B. Shine Department of Rheumatology, Rambam Medical Center and B. Rappaport Faculty of Medicine, Israel-Technion Institute of Technology, 9602, Haifa, 31096, Israel

    A. P. Rozin & A. M. Nahir

Authors
  1. A. P. Rozin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. M. Nahir
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. P. Rozin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Rozin, A.P., Nahir, A.M. Is SAPHO syndrome a target for antibiotic therapy?. Clin Rheumatol 26, 817–820 (2007). https://doi.org/10.1007/s10067-006-0274-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-006-0274-6

Keywords

Search

Navigation