Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study.
Pediatr Rheumatol Online J
; 13: 25, 2015 Jun 19.
Article
in En
| MEDLINE
| ID: mdl-26088861
ABSTRACT
BACKGROUND:
To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease.METHODS:
Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome.RESULTS:
Forty-one children (31 girls and 10 boys) from 6 pediatric hospitals in Switzerland diagnosed between 1995 and 2010 were included in the study. The diagnosis was multifocal CNO (n = 33), unifocal CNO (n = 4) and SAPHO syndrome (n = 4). Mean age at onset of CNO was 9.5 years (range 1.4-15.6) and mean follow-up time was 52 months (range 6-156 months). Most patients (n = 27) had a chronic persistent disease course (>6 months), 8 patients had a course with one or more relapses and 6 patients had only one episode of CNO. Forty nine percent had received at least one course of antibiotics. In 57% treatment with nonsteroidal anti-inflammatory drugs (NSAID) was sufficient to control the disease. Twelve out of 16 children with NSAID failure subsequently received corticosteroids, methotrexate, TNF α inhibitors, bisphosphonates or a combination of these drugs.CONCLUSIONS:
In a multicenter cohort of 41 children 22% started with unifocal lesion with a significant diagnostic delay. A higher proportion presented with chronic persistent disease than with a recurrent form. An osteomyelitis in the pelvic region is significantly associated with other features of juvenile spondylarthritis.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Anti-Inflammatory Agents, Non-Steroidal
/
Methotrexate
/
Adrenal Cortex Hormones
/
Acquired Hyperostosis Syndrome
/
Anti-Bacterial Agents
Type of study:
Diagnostic_studies
/
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
Europa
Language:
En
Journal:
Pediatr Rheumatol Online J
Year:
2015
Type:
Article
Affiliation country:
Switzerland