1. BILATERAL ACUTE ANTERIOR UVEITIS ASSOCIATED TO SAPHO SYNDROME
Castaño Martín B , Rubio Álvarez N, Vleming Pinilla E, Muñoz Gutierrez B
Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Madrid.

2. CLINICAL CASE 35-year-old woman.
PH: hypothyroidism, chronic espondiloarthropathy and acute anterior uveitis outbreaks in Romania.
Complaints right and painfull red eye.
BM: Tyndall 3+, posterior synechiae and retrokeratic pigmentary deposits .
No findings in ocular fundus, IOP and VA.
Diagnosis: right unilateral anterior uveitis.

3. Evolution
Systemic assessment: HLA-B27 + and past HBV serology, the rest analysis were negative including Mantoux test. Radiology of sacroiliac joints showed bone step with joint effacement(FIG.1)
A year later she presented bilateral acute anterior uveitis.
FIGURE 1: radiology of sacroiliac joints

4. Currently, she remains asymptomatic
In the next 4 month, she presented pustular lessions in palms (FIG.2) and hidradenitis suppurativa. Dermatology Service diagnosed it as SAPHO syndrome.
She presented 3 alternating episodes of UAA in both eyes in and worsening of the systemic disease. Treatment with metotrexate was not enough to control the simptoms and together, with the reumatologist ,we decided to associate treatment with Golimumab.
Currently, she remains asymptomatic
FIGURE 2: pustular lessions in palms

5. BIBLIOGRAPHY: 1. Carneiro, Sueli, MD, PhD; Sampaio-Barros, Percival D
BIBLIOGRAPHY: 1. Carneiro, Sueli, MD, PhD; Sampaio-Barros, Percival D. SAPHO syndrome .Rheumatic Diseases Clinics of North America. 2013, May;39(4): Nguyen MT, Borchers A et al. The SAPHO syndrome. Semin Arthrithis Rheum 2012 Dec; 42(3): Leirisalo-Repo Met al. Enteropathic arthritis, Whipple’s disease, juvenile spondyloarthropathy, uveitis, and SAPHO syndrome. Curr Opin Rheumatol Jul; 7(4): Steinhoff JP, Cilursu A, Falasca GF, et al. A study of musculoskeletal manifestations in 12 patients with SAPHO syndrome. J Clin Rheumatol De Armas EM, Rocha P, Lozano V, Losada MJ, Rodriguez B, Serrano MÁ. Macular edema in SAPHo Syndrome. CASO CLÍNICO. ARCH. SOC. CANAR. OFTAL., 2013; 24: 82-84