Turkiye Klinikleri Journal of Pediatrics

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Anterior Chest Wall Involvement in a Child with Familial Mediterranean Fever: A Rare Manifestation and Diagnostic Challenge
Ailesel Akdeniz Ateşi Olan Bir Çocukta Göğüs Ön Duvar Tutulumu: Nadir Bir Görünüm ve Tanı Zorluğu
Hakan KISAOĞLUa , Özge BABAa , Mukaddes KALYONCUa
aKaradeniz Technical University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Rheumatology, Trabzon, Türkiye
Turkiye Klinikleri J Pediatr. 2024;33(1):30-4
doi: 10.5336/pediatr.2023-97702
Article Language: EN
Full Text
ABSTRACT
 Anterior chest wall involvement is frequently seen in adult patients with spondyloarthropathy and often related to advanced axial disease and rarely reported in pediatric patients. In addition, anterior chest wall involvement is frequently encountered in patients with synovitis, acne, pustulosis, hyperostosis and osteitis (SAPHO) syndrome. Despite treatments of these conditions were similar, differentiation of these two diseases might be challenging due to the overlapping features. Also, several rheumatic diseases, including spondyloarthropathy, could be seen in association with familial Mediterranean fever (FMF). Additionally, treatment of cases with concomitant FMF and spondyloarthropathy might be challenging due to the different biological drug needs of the diseases. Herein, we presented a case of sternoclavicular arthritis in a pediatric FMF patient for the first time and emphasize on the challenges in differentiating SAPHO from spondyloarthropathy and difficulties in treatment.

Keywords: Acquired hyperostosis syndrome; axial spondyloarthritis; familial Mediterranean fever; sternoclavicular joint; thoracic wall
ÖZET
 Göğüs ön duvarı tutulumu spondiloartropatili erişkin hastalarda sıklıkla görülür ve ilerlemiş aksiyel hastalıkla ilişkili olup çocuklarda nadiren bildirilir. Ayrıca sinovit, akne, püstüloz, hiperostoz ve osteitis (SAPHO) sendromlu hastalarda göğüs ön duvarı tutulumuna sıklıkla rastlanmaktadır. Bu hastalıkların tedavileri benzer olmasına rağmen örtüşen özellikleri nedeniyle ayırt edilmesi zor olabilir. Ayrıca spondiloartropati dâhil birçok romatizmal hastalık ailesel Akdeniz ateşi (AAA) ile birlikte görülebilir. Ayrıca AAA ve spondiloartropati birlikteliği olan olguların tedavisi, hastalıkların farklı biyolojik ilaç gereksinimleri nedeniyle zorlayıcı olabilir. Burada ilk kez pediatrik bir AAA hastasında sternoklaviküler artrit olgusunu sunarak SAPHO'yu spondiloartropatiden ayırmada ve tedavideki zorluklara vurgu yaptık.

Anahtar Kelimeler: Kazanılmış hiperostozis sendromu; aksiyel spondiloartrit; ailesel Akdeniz ateşi; sternoklaviküler eklem; göğüs duvarı
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