[Successful therapy of sacroiliitis in SAPHO syndrome by etanercept].
Painful, aseptic osteitis remains the major problem in the treatment of patients with SAPHO syndrome. We present a child suffering of both sacroiliitis and acne conglobata in the context of SAPHO syndrome. While acne lesions responded well to systemic isotretinoin, sacroiliitis associated pain could be controlled neither by NSAR nor by intralesional or systemic steroid injection. Worse pain limited substantially patient's mobility. This changed immediately after starting etanercept. Within a few days, pain resolved and the patient regained his mobility. This favourable response lasted for 8 months when we tried to stop etanercept under protection with the DMARD sulfazalazin. Unfortunately, within a few days, pain and immobility re-occurred requiring reinstitution of etanercept. This case demonstrates that, similar to other reports, TNF blockade is able to induce prompt and long-lasting response of SAPHO syndrome associated osteoarthritis to TNF blockade.
Dermatologische Abteilung, Sozialmedizinische Zentrum Ost, Donauspital, Wien, Austria. carola.wolber@wienkav.at
Carola
C
Wolber
Karin
K
David-Jelinek
Astrid
A
Udvardi
Gottfried
G
Artacker
Beatrix
B
Volc-Platzer
Herbert
H
Kurz
D000152:Acne Vulgaris / Q000175:diagnosis / Q000188:drug therapy; D020083:Acquired Hyperostosis Syndrome / Q000175:diagnosis / Q000188:drug therapy*; D000293:Adolescent; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001317:Austria; D000068800:Etanercept; D006801:Humans; D007074:Immunoglobulin G / Q000009:adverse effects / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D051346:Mobility Limitation; D010147:Pain Measurement / Q000187:drug effects; D018124:Receptors, Tumor Necrosis Factor / Q000627:therapeutic use*; D058566:Sacroiliitis / Q000175:diagnosis / Q000188:drug therapy*; D013167:Spondylitis, Ankylosing / Q000175:diagnosis / Q000188:drug therapy; D014421:Turkey / Q000208:ethnology
D018501:Antirheumatic Agents; D007074:Immunoglobulin G; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept
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