0
Communications to the Editor |

Pleural Effusion Associated With the SAPHO Syndrome FREE TO VIEW

Jaime Fernandez-Campillo, MD; Eduardo Garcia-Pachon, MD
Author and Funding Information

Hospital Vega Baja Orihuela-Alicante, Spain

Correspondence to: Eduardo Garcia-Pachon, MD, Department of Internal Medicine, Hospital Vega Baja, E-03314 Orihuela-Alicante, Spain; e-mail egpachon@latinmail.com



Chest. 2001;120(5):1752. doi:10.1378/chest.120.5.1752
Text Size: A A A
Published online

To the Editor:

The acronym SAPHO (for synovitis, acne, pustulosis, hyperostosis, and osteitis syndrome) was first proposed in 1987 as a unifying concept to describe the association between musculoskeletal disorders and various dermatologic conditions.1Since then, there has been an increasing interest in recognizing and characterizing this syndrome.23 Patients with pulmonary infiltrates and respiratory symptoms have been described occasionally45; but, to our knowledge, pleural involvement has not been mentioned.

In November 1998, a 61-year-old man was admitted to our hospital because of a right pleural effusion. He reported pain in both shoulders and in the left hip, accompanied by stiffness of the chest wall and exertional dyspnea, all symptoms having been present for the previous month. The pleural fluid was a straw-colored, eosinophilic exudate with the following measurable characteristics: pH, 7.38; glucose, 93 mg/dL; protein, 5.1 mg/dL; and lactate dehydrogenase, 506 U/L. Rheumatoid factor, antinuclear antibody, adenosine deaminase, carcinoembryonic antigen, and microbiological and cytologic analysis results were all normal or negative. Complement studies were not performed. The patient had no history of exposure to asbestos, and an extensive diagnostic study (which included a CT scan, nuclear scintigraphy, and echocardiography) did not find the cause of the effusion, which resolved. During the following 12 months, the patient presented the features that established the diagnosis of the SAPHO syndrome (scalp psoriasis, synovitis of the shoulder, pain in the anterior chest wall, and pubic osteitis), and he experienced a worsening of his exertional dyspnea. Pulmonary function tests showed a moderately restrictive defect. In the CT scan, a localized right pleural thickening was seen.

We speculate that the pleural effusion may be associated with the SAPHO syndrome because the pleurisy and the musculoskeletal symptoms started at the same time, and because no other cause for the effusion was found. Although it may be an incidental coincidence, we wish to alert clinicians to this possible diagnosis, bearing in mind that the SAPHO syndrome has been described recently and is still not widely known.

References

Chamot, AM, Benhamou, CL, Kahn, MF, et al (1987) Le syndrome acné pustulose hyperostose ostéite (SAPHO): résultats d’ une enquête nationale: 85 observations.Rev Rhum Mal Osteoartic54,187-196. [PubMed]
 
Hayem, G, Bouchaut-Chabot, A, Benali, K, et al SAPHO syndrome: a long-term follow-up study of 120 cases.Semin Arthritis Rheum1999;29,159-171. [PubMed] [CrossRef]
 
Van Doornum, S, Barrachough, D, McColl, G, et al SAPHO: rare or just not recognized?Semin Arthritis Rheum2000;30,70-77. [PubMed]
 
Vaile, JH, Langlands, DR, Prichard, MG SAPHO syndrome: a new pulmonary manifestation?J Rheumatol1995;22,2190-2191. [PubMed]
 
Ravelli, A, Martini, A SAPHO syndrome and pulmonary disease.J Rheumatol1996;23,1482-1483. [PubMed]
 

Figures

Tables

References

Chamot, AM, Benhamou, CL, Kahn, MF, et al (1987) Le syndrome acné pustulose hyperostose ostéite (SAPHO): résultats d’ une enquête nationale: 85 observations.Rev Rhum Mal Osteoartic54,187-196. [PubMed]
 
Hayem, G, Bouchaut-Chabot, A, Benali, K, et al SAPHO syndrome: a long-term follow-up study of 120 cases.Semin Arthritis Rheum1999;29,159-171. [PubMed] [CrossRef]
 
Van Doornum, S, Barrachough, D, McColl, G, et al SAPHO: rare or just not recognized?Semin Arthritis Rheum2000;30,70-77. [PubMed]
 
Vaile, JH, Langlands, DR, Prichard, MG SAPHO syndrome: a new pulmonary manifestation?J Rheumatol1995;22,2190-2191. [PubMed]
 
Ravelli, A, Martini, A SAPHO syndrome and pulmonary disease.J Rheumatol1996;23,1482-1483. [PubMed]
 
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543