A Case of the SAPHO Syndrome Which Became Clear Taking Advantage of Pain after Tooth Extravtion

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  • FUJIWARA KEIKO
    Division of First Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry
  • MORI KAZUMASA
    Division of First Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry
  • MINAMI HIROKO
    Kusunoki Hospital
  • SHIMADA JUN
    Division of First Oral and Maxillofacial Surgery, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry

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  • 抜歯後疼痛を機に判明したSAPHO症候群の1例

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Abstract

SAPHO （Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis Syndrome） syndrome is a systemic disease consisting of unexplained pustular skin lesions and osteoarthritic lesions, and was reported by Chamot et al. in 1987. The present study reports a rare case of SAPHO syndrome in an adult male. A 42-year-old male outpatient came to the Department of Oral and Maxillofacial Surgery for a consultation with the chief complaint of persistent pain following extraction of the first premolar on the right side of the lower jaw. Computed tomography （CT） showed diffuse osteosclerosis with indistinct boundaries in the premolar region on the right side of the lower jaw. According to the results of MRI, a low signal area in this region was observed on T1-weighted images, while a high signal area was observed on T2-weighted images. Tc̄99 scintigraphy revealed an increased accumulation in the right lower jaw, bilateral sternoclavicular joints, and finger/toe joints. The patient had a history of palmoplantar pustulosis and chest/joint pain. Blood tests indicated normal values for rheumatoid factors, anti-CCP antibodies, and antinuclear antibodies, whereas an increasing tendency in leukocytes and CRP levels was detected. SAPHO syndrome was strongly suspected, hence macrolide antibiotics （Clarith®） and NSAIDs were prescribed, resulting in improvement of the patient.

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