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SAT0592 Hrct pulmonary manifestations in patients with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO)syndrome
  1. S. Liu1,
  2. C. Li2,
  3. W. Song3,
  4. W. Xu4,
  5. K. Xu4,
  6. W. Zhang5,
  7. X. Tian4
  1. 1Peking Union Medical College
  2. 2Traditional Chinese Medicine
  3. 3Radiology
  4. 4Respiratory medicine
  5. 5Rheumatology, Peking Union Medical College Hospital, Beijing, China


Background Synovitis, acne, palmoplantarpustulosis, hyperostosis and osteitis syndrome (SAPHO) is a rare syndrome that affects the skin, bones and joints.1 SAPHO syndrome shares a variety of features with the seronegative spondyloarthropathies (SpAs), such as psoriatic arthritis (PsA).1 While the extra-articular manifestations of PsA are well defined, the systemic involvements of SAPHO syndrome are only reported occasionally.2 Previous cases of accompanied pleural effusion3, 4 and organising pneumonia(5were reported. In clinical work, we observed that pulmonary lesions progressed when diseases aggravated. However, the relationship between pulmonary manifestations and diseases activity remains unclear.

Objectives This study is to explore the pulmonary comorbidity with SAPHO syndrome.

Methods Pulmonary HRCT images were reconstructed from whole-spine CT images in 67 SAPHO patientsHRCT images of 58 healthy controls were obtained and reviewed. Pneumonia and tuberculosis were excluded. We investigated the presence of different HRCT images findings with detailed examinations.

Results In detailed HRCT evaluations, abnormalities were identified in 45 of all patients. We found stripe in 29 (43.3%) cases, patchy shadows in 22 (32.8%), ground-glass opacity in 11 (16.4%), pleural thickening in 9 (13.4%), solitary nodule in 6 (9%), bronchiectasis in 3 (4.5%), pulmonary bulla in 2 (3%), multiple nodules in 1 (1.5%), and interstitial change in 1 (1.5%). Compared with healthy controls, SAPHO patients have significantly higher rate of patchy shadows while significantly lower percentage of nodules (especially multiple nodules), although the overall rates of abnormal HRCT findings are similar.

Abstract SAT0592 – Figure 1

HRCT images in 3 SAPHO patients. A: Ground glass opacities (arrows); B: Solitary nodule (arrow); C: Interstitial change (arrow).

Conclusions Our study was the first to study HRCT pulmonary changes in SAPHO patients. SAPHO patients have significantly higher percentage of patchy shadows and significantly lower rate of pulmonary nodules than healthy controls. BASDAI and age are possible good predictors for abnormal HRCT pulmonary findings.

References [1] Nguyen MT, Borchers A, Selmi C, et al. The SAPHO syndrome. Semin Arthritis Rheum2012;42(3):254–65.

[2] Rozin AP, Hasin T, Toledano K, et al. Seronegative polyarthritis as severe systemic disease. Neth J Med2010;68(6):236–41.

[3] Fernandez-Campillo J, Garcia-Pachon E. Pleural effusion associated with the SAPHO syndrome. Chest. 2001;120(5):1752.

[4] Hasegawa S, Yabe H, Kaneko N, et al. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) Syndrome with Significant Bilateral Pleural Effusions. Intern Med2017;56(20):2779–83.

[5] Hameed F, Steer H. A case of bronchiolitis obliterans organising pneumonia associated with SAPHO (synovitis-acne-pustulosis-hyperostosis-osteitis) syndrome. BMJ Case Rep2017;2017.

Disclosure of Interest None declared

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