儿童SAPHO综合征1例

Case report of SAPHO syndrome in children

回顾性分析2020年3月山东大学附属省立医院小儿肾脏风湿免疫科收治的1例SAPHO综合征患儿资料。患儿,男,14岁,因"痤疮2个月余,发热50余天,髋关节疼痛2周"入院。患儿病初按"痤疮合并感染"、"关节炎"于多家医院、多个科室就诊,治疗2个月余,效果欠佳。入院初拟诊为"幼年特发性关节炎、痤疮合并感染",予抗感染、抗炎等对症支持治疗,病情进行性加重。经多学科会诊及完善相关检查后最终考虑诊断"SAPHO综合征",予塞来昔布、柳氮磺胺吡啶、重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白等治疗后,患儿临床症状明显减轻。SAPHO综合征临床罕见,儿童尤著,极易误诊、漏诊。提示临床工作中如接诊痤疮患儿,尤其同时合并关节炎者,应高度怀疑此病并尽早诊治。

Retrospective analysis.To report a child with synovitis,acne,pustulosis,hyperostosis,osteitis(SAPHO)syndrome admitted to the Department of Pediatric Nephrology and Rheumatology,Shandong Provincial Hospital,Cheeloo College of Medicine,Shandong University in March 2020.A 14-year-old boy presented to hospital due to acne for more than 2 months,fever for more than 50 days,and hip pain for 2 weeks.The patient was diagnosed and treated as acne combined with infection and arthritis in other hospitals for more than 2 months without remission.He was initially diagnosed as juvenile idiopathic arthritis,acne combined with infection on admission.The disease was aggravated even after medications of anti-infection and anti-inflammatory drugs.After multidisciplinary consultation,the patient was diagnosed as SAPHO syndrome.The patient recovered from medications of Celecoxib,Sulfasalazine,recombinant human tumor necrosis factor receptorⅡ:IgG Fc fusion protein and other drugs.SAPHO syndrome is rare,especially in children,which is easily misdiagnosed.This case report suggested that SAPHO should be considered in children with acne,especially those combined with arthritis.