高度の頚椎破壊性変化を来したSAPHO症候群の1例

SAPHO Syndrome with the Severely Destructive Lesion of the Cervical Spine. Case Report

　SAPHO症候群は皮膚病変と骨関節病変により構成される症候群である．骨関節病変は前胸部が最も多く，脊椎にも約30％にみられるが，高度の骨破壊を来すことは稀である．症例は56歳，女性，頚椎に高度の骨破壊性病変を認めた．前胸部の症状がなく，皮膚病変も軽度であったため，初期診断に難渋したが，頚椎前方固定術を施行した際の病理組織検査と細菌培養検査により，本症候群に伴う脊椎炎と診断した．高度の脊椎破壊性変化を生じうる疾患として，本症候群を念頭に置く必要がある．

　SAPHO syndrome is characterized by a combination of skin and musculoskeletal lesions. The anterior chest wall is the most frequent localization, and spinal lesions are present in about 30％ of the cases, but the bone lesions are seldom severely destructive. We report the case of 56-year-old woman with a severely destructive lesion of cervical spine. It was difficult to diagnose SAPHO syndrome, because there were no anterior chest wall symptoms and her skin lesions were so mild that she had neglected them. Following examination of a bone biopsy specimen and culture at the site of the curettage and anterior fusion, we diagnosed the lesion as spondylitis as part of the SAPHO syndrome (not as infectious spondylitis). SAPHO syndrome should be included in the differential diagnosis of diseases that involve severely destructive changes in the spine.