Case report: remarkable remission of SAPHO syndrome in response to Tripterygium wilfordii hook f treatment.
Palabras clave
Abstracto
BACKGROUND
SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome is an autoinflammatory disease with no standardized treatment. Tripterygium wilfordii hook f (TwHF) is a Chinese herb with immunosuppressive effects and has been used to treat some chronic inflammatory diseases. However, it has not been reported as a therapeutic option in SAPHO syndrome. Here we present the first report in which a remarkable remission of SAPHO syndrome was achieved in response to TwHF.
UNASSIGNED
A 57-year-old female patient noted swelling and pain at the anterior chest wall and scattered rashes like psoriasis vulgaris. Bone scintigraphy demonstrated the classic "bull's head" sign and magnetic resonance images indicated bone marrow edema on T5.
UNASSIGNED
The diagnosis was made by dermatological and osteoarticular manifestations and classical "bull's head" sign in bone scintigraphy.
METHODS
TwHF with a priming dose of 20 mg 3 times per day and a gradual dose reduction of 20 mg per day in every 3 months. Four months later, methotrexate was added with 10 mg per week.
RESULTS
Osteoarticular symptoms and radiological abnormalities were improved dramatically.
CONCLUSIONS
This case illustrates a promising strategy to treat SAPHO syndrome.
