A case report of SAPHO syndrome complicated by acute coronary syndrome

Synovitis, Acne, Pustulosis, Hyperostosis, and Osteitis (SAPHO) syndrome is a rare inflammatory disorder affecting the skin, bones, and joints. Here, we report a 19-year-old male patient with SAPHO syndrome presenting with polyarthralgia, severe acne, and elevated inflammatory makers. During hospitalization, the patient experienced acute episodes of nocturnal, rest-associated precordial pain. Acute Coronary Syndrome (ACS) was diagnosed based on clinical symptoms, dynamic electrocardiogram (ECG) changes, and elevated myocardial enzymes. Following aggressive immunomodulatory management for SAPHO syndrome with methotrexate and non-steroidal anti-inflammatory drugs (NSAIDs), combined with myocardial metabolic support using trimetazidine, the patient's precordial pain resolved remarkably, with normal post-treatment ECG and myocardial enzymes. This case demonstrates that the systemic inflammatory state of SAPHO syndrome may precipitate acute coronary events. Clinicians must maintain high vigilance for potential cardiovascular complications in patients with SAPHO syndrome to ensure timely intervention.