title: Ilium osteitis as the main manifestation of the SAPHO syndrome: response to infliximab therapy and review of the literature.
abstract: OBJECTIVE
  To analyze the clinical efficacy of anti-tumor necrosis factor (TNF)-alpha therapy in the SAPHO (synovitis, acne, pustulosis, hyperostosis, osteitis) syndrome. We describe 2 new cases with ilium osteitis as the main SAPHO syndrome feature and review reported cases treated with anti-TNF-alpha.
  
  
  METHODS
  A literature search of SAPHO syndrome cases treated with TNF-alpha blocking therapy with special emphasis on osteoarticular and skin responses was performed.
  
  
  RESULTS
  Eighteen cases were identified: 17 SAPHO syndrome and 1 chronic recurrent multifocal osteomyelitis, a juvenile variant of SAPHO syndrome. Sixteen were reported cases and 2 were nonreported cases seen in our arthritis unit. Sixteen patients received infliximab and 2 received etanercept, with an early, sustained clinical improvement in most cases.
  
  
  CONCLUSIONS
  Anti-TNF-alpha therapies are effective treatment for patients with refractory SAPHO syndrome, not only for cutaneous lesions but also for persistent bone lesions such as osteitis.
authors.affiliation: Arthritis Unit, Rheumatology Department, Hospital Clínic, University of Barcelona, Barcelona, Spain.
authors.forename: Concepción
authors.initials: C
authors.lastname: Moll
authors.forename: M Victoria
authors.initials: MV
authors.lastname: Hernández
authors.forename: Juan D
authors.initials: JD
authors.lastname: Cañete
authors.forename: José A
authors.initials: JA
authors.lastname: Gómez-Puerta
authors.forename: Alex
authors.initials: A
authors.lastname: Soriano
authors.forename: Antonio
authors.initials: A
authors.lastname: Collado
authors.forename: Raimon
authors.initials: R
authors.lastname: Sanmartí
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D006801:Humans; D007085:Ilium; D000069285:Infliximab; D010000:Osteitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors
chemical_list: D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab