title: Bilateral Subclavian Vein Occlusion in a SAPHO Syndrome Patient Who Needed an Implantable Cardioverter Defibrillator.
abstract: A 79-year-old Asian man was hospitalized because of progressive exertional dyspnea with decreasing left ventricular ejection fraction and frequent non-sustained ventricular tachycardia. Pre-procedure venography for implantable cardioverter defibrillator (ICD) implantation showed occlusion of the bilateral subclavian veins. In consideration of subcutaneous humps in the sterno-clavicular area and palmoplantar pustulosis, we diagnosed him as having synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) syndrome and speculated that it induced peri-osteal chronic inflammation in the sterno-clavicular area, resulting in occlusion of the adjacent bilateral subclavian veins. An automatic external defibrillator (AED) was installed in the patient's house and total subcutaneous ICD was considered. Venous thrombosis in SAPHO syndrome is not frequent but has been reported. To the best of our knowledge, this is the first case of bilateral subclavian vein occlusion in a SAPHO syndrome patient who needs ICD implantation.
authors.affiliation: Department of Cardiology, Japanese Red Cross Medical Center.
authors.forename: Masato
authors.initials: M
authors.lastname: Ishizuka
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yamada
authors.forename: Sonoko
authors.initials: S
authors.lastname: Maemura
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakata
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Motozawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Masataka
authors.initials: M
authors.lastname: Takizawa
authors.forename: Hiroki
authors.initials: H
authors.lastname: Uozumi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikenouchi
mesh_terms: D020083:Acquired Hyperostosis Syndrome / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D000368:Aged; D047548:Defibrillators; D017147:Defibrillators, Implantable; D019468:Disease Management; D006801:Humans; D008297:Male; D010690:Phlebography / Q000379:methods; D013350:Subclavian Vein / Q000000981:diagnostic imaging / Q000473:pathology; D017180:Tachycardia, Ventricular / Q000150:complications / Q000517:prevention & control*; D020246:Venous Thrombosis / Q000175:diagnosis / Q000209:etiology