Sacroiliitis, hyperostosis sternoclavicularis, and psoriasis palmoplantaris in monozygotic twins

Abstract

Two 46-year-old monozygotic female twins each presented with a 10-year history of inflammatory low back pain, impaired mobility of the lower spine, and painful swelling of the sternoclavicular joints. At presentation, 1 twin had erythemato-squamous lesions typical of psoriasis on the palms of both hands and feet ( Figure 1). The other reported having had identical cutaneous lesions in the past. Laboratory investigations showed elevated erythrocyte sedimentation rates of 50 mm/hour and 21 mm/hour and C-reactive protein levels of 30 mg/liter and 17 mg/liter, respectively. Other laboratory investigations, including rheumatoid factor testing, polymerase chain reaction analysis for Chlamydia trachomatis from morning urine, and enzyme-linked immunosorbent assay for Yersinia yielded normal or negative results. Both twins were HLA-B27 negative (HLA-A2,-;B38,B44;Cw5,-;DRB1 04,13).

Rückenschmerzen und „Handekzem”

“…Eine Assoziation des SAPHO-Syndroms mit dem HLA-B27-Antigen wird kontrovers beurteilt (5,6). Es wird nur vereinzelt über eine familiäre Häufung des SAPHO-Syndroms berichtet, beispielsweise bei eineiigen Zwillingen (11).…”