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01-04-2012 | PEDIATRIC RHEUMATOLOGY (TJA LEHMAN, SECTION EDITOR)

Current Understanding of the Pathogenesis and Management of Chronic Recurrent Multifocal Osteomyelitis

Authors: Polly J. Ferguson, Monica Sandu

Published in: Current Rheumatology Reports | Issue 2/2012

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is an inflammatory disorder that primarily affects children. Its hallmark is recurring episodes of sterile osteomyelitis. The clinical presentation is insidious onset of bone pain with or without fever. Laboratory studies typically reveal nonspecific evidence of inflammation. Radiologic imaging and histologic appearance resemble those of infectious osteomyelitis. There is a strong association with inflammatory disorders of the skin and intestinal tract in affected individuals and their close relatives, suggesting a shared pathophysiology and supporting a genetic component to disease susceptibility. Two genetic syndromes have CRMO as a prominent phenotype—Majeed syndrome and deficiency of the interleukin-1 receptor antagonist—and suggest that interleukin-1 may be a key cytokine in disease pathogenesis. This review briefly summarizes the main clinical and radiologic aspects of the disease and then focuses on genetics and pathophysiology and provides an update on treatment.

Jansson A, Renner ED, Ramser J, Mayer A, Haban M, Meindl A, Grote V, Diebold J, Jansson V, Schneider K, Belohradsky BH. Classification of non-bacterial osteitis: retrospective study of clinical, immunological and genetic aspects in 89 patients. Rheumatol (Oxford). 2007;46:154–60.CrossRef

Girschick HJ, Raab P, Surbaum S, Trusen A, Kirschner S, Schneider P, Papadopoulos T, Muller-Hermelink HK, Lipsky PE. Chronic non-bacterial osteomyelitis in children. Ann Rheum Dis. 2005;64:279–85.PubMedCrossRef

El-Shanti HI, Ferguson PJ. Chronic recurrent multifocal osteomyelitis: a concise review and genetic update. Clin Orthop Relat Res. 2007;462:11–9.PubMedCrossRef

Schultz C, Holterhus PM, Seidel A, Jonas S, Barthel M, Kruse K, Bucsky P. Chronic recurrent multifocal osteomyelitis in children. Pediatr Infect Dis J. 1999;18:1008–13.PubMedCrossRef

Huber AM, Lam PY, Duffy CM, Yeung RS, Ditchfield M, Laxer D, Cole WG, Kerr Graham H, Allen RC, Laxer RM. Chronic recurrent multifocal osteomyelitis: clinical outcomes after more than five years of follow-up. J Pediatr. 2002;141:198–203.PubMedCrossRef

6. •

Khanna G, Sato TS, Ferguson P. Imaging of chronic recurrent multifocal osteomyelitis. Radiographics. 2009;29:1159–77. This article provides comprehensive examples of the various radiologic manifestations of CRMO.PubMedCrossRef

•• Hofmann SR, Schwarz T, Moller JC, Morbach H, Schnabel A, Rosen-Wolff A, Girschick HJ, Hedrich CM. Chronic non-bacterial osteomyelitis is associated with impaired Sp1 signaling, reduced IL10 promoter phosphorylation, and reduced myeloid IL-10 expression. Clin Immunol. 2011;141:317–27. This article presents data that implicate IL-10 dysregulation in disease pathogenesis.PubMedCrossRef

Girschick HJ, Huppertz HI, Harmsen D, Krauspe R, Muller-Hermelink HK, Papadopoulos T. Chronic recurrent multifocal osteomyelitis in children: diagnostic value of histopathology and microbial testing. Hum Pathol. 1999;30:59–65.PubMedCrossRef

Jurik AG, Egund N. MRI in chronic recurrent multifocal osteomyelitis. Skeletal Radiol. 1997;26:230–8.PubMedCrossRef

10.

Bjorksten B, Gustavson KH, Eriksson B, Lindholm A, Nordstrom S. Chronic recurrent multifocal osteomyelitis and pustulosis palmoplantaris. J Pediatr. 1978;93:227–31.PubMedCrossRef

11.

Sasaki T. A case of osteomyelitis of the bilateral clavicles associated with pustulosis palmaris et plantaris. Rinsho Seikeigeka. 1967;2:333–7.

12.

Paller AS, Pachman L, Rich K, Esterly NB, Gonzalez-Crussi F. Pustulosis palmaris et plantaris: its association with chronic recurrent multifocal osteomyelitis. J Am Acad Dermatol. 1985;12:927–30.PubMedCrossRef

13.

Kawai K, Doita M, Tateishi H, Hirohata K. Bone and joint lesions associated with pustulosis palmaris et plantaris. A clinical and histological study. J Bone Joint Surg Br. 1988;70:117–22.PubMed

14.

Bergdahl K, Bjorksten B, Gustavson KH, Liden S, Probst F. Pustulosis palmoplantaris and its relation to chronic recurrent multifocal osteomyelitis. Dermatologica. 1979;159:37–45.PubMedCrossRef

15.

Laxer RM, Shore AD, Manson D, King S, Silverman ED, Wilmot DM. Chronic recurrent multifocal osteomyelitis and psoriasis—a report of a new association and review of related disorders. Semin Arthritis Rheum. 1988;17:260–70.PubMedCrossRef

16.

Schilling F, Marker-Hermann E. Chronic recurrent multifocal osteomyelitis in association with chronic inflammatory bowel disease: entheropathic CRMO. Z Rheumatol. 2003;62:527–38.PubMedCrossRef

17.

Bazrafshan A, Zanjani KS. Chronic recurrent multifocal osteomyelitis associated with ulcerative colitis: a case report. J Pediatr Surg. 2000;35:1520–2.PubMedCrossRef

18.

Jo Y, Matsumoto T, Nagamine R. A case of Crohn’s disease with leg pain. Br J Radiol. 2001;74:203–4.PubMed

19.

Bognar M, Blake W, Agudelo C. Chronic recurrent multifocal osteomyelitis associated with Crohn’s disease. Am J Med Sci. 1998;315:133–5.PubMedCrossRef

20.

Bousvaros A, Marcon M, Treem W, Waters P, Issenman R, Couper R, Burnell R, Rosenberg A, Rabinovich E, Kirschner BS. Chronic recurrent multifocal osteomyelitis associated with chronic inflammatory bowel disease in children. Dig Dis Sci. 1999;44:2500–7.PubMedCrossRef

21.

Carpenter E, Jackson MA, Friesen CA, Scarbrough M, Roberts CC. Crohn’s-associated chronic recurrent multifocal osteomyelitis responsive to infliximab. J Pediatr. 2004;144:541–4.PubMedCrossRef

22.

Kahn MF, Bouchon JP, Chamot AM, Palazzo E. Chronic enterocolopathies and SAPHO syndrome. 8 cases. Rev Rhum Mal Osteoartic. 1992;59:91–4.PubMed

23.

Prose NS, Fahrner LJ, Miller CR, Layfield L. Pustular psoriasis with chronic recurrent multifocal osteomyelitis and spontaneous fractures. J Am Acad Dermatol. 1994;31:376–9.PubMedCrossRef

24.

•• Aksentijevich I, Masters SL, Ferguson PJ, Dancey P, Frenkel J, van Royen-Kerkhoff A, Laxer R, Tedgard U, Cowen EW, Pham TH, Booty M, Estes JD, Sandler NG, Plass N, Stone DL, Turner ML, Hill S, Butman JA, Schneider R, Babyn P, El-Shanti HI, Pope E, Barron K, Bing X, Laurence A, Lee CC, Chapelle D, Clarke GI, Ohson K, Nicholson M, Gadina M, Yang B, Korman BD, Gregersen PK, van Hagen PM, Hak AE, Huizing M, Rahman P, Douek DC, Remmers EF, Kastner DL, Goldbach-Mansky R. An autoinflammatory disease with deficiency of the interleukin-1-receptor antagonist. N Engl J Med. 2009;360:2426–37. This study identified mutations in a key IL-1 pathway gene in children with generalized pustulosis and CRMO—a novel autoinflammatory syndrome named DIRA.PubMedCrossRef

25.

•• Reddy S, Jia S, Geoffrey R, Lorier R, Suchi M, Broeckel U, Hessner MJ, Verbsky J. An autoinflammatory disease due to homozygous deletion of the IL1RN locus. N Engl J Med. 2009;360:2438–44. This study also identified mutations in a key IL-1 pathway gene in children with generalized pustulosis and CRMO—a novel autoinflammatory syndrome named DIRA.PubMedCrossRef

26.

Edwards TC, Stapleton FB, Bond MJ, Barrett FF. Sweet’s syndrome with multifocal sterile osteomyelitis. Am J Dis Child. 1986;140:817–8.PubMed

27.

Majeed HA, Kalaawi M, Mohanty D, Teebi AS, Tunjekar MF, al-Gharbawy F, Majeed SA, al-Gazzar AH. Congenital dyserythropoietic anemia and chronic recurrent multifocal osteomyelitis in three related children and the association with Sweet syndrome in two siblings. J Pediatr. 1989;115:730–4.PubMedCrossRef

28.

Arndt JH. Sweet’s syndrome and chronic recurrent multifocal osteomyelitis [letter]. Am J Dis Child. 1987;141:721.PubMed

29.

Nurre LD, Rabalais GP, Callen JP. Neutrophilic dermatosis-associated sterile chronic multifocal osteomyelitis in pediatric patients: case report and review. Pediatr Dermatol. 1999;16:214–6.PubMedCrossRef

30.

Tlougan BE, Podjasek JO, O’Haver J, Cordova KB, Nguyen XH, Tee R, Pinckard-Hansen KC, Hansen RC. Chronic recurrent multifocal osteomyelitis (CRMO) and synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome with associated neutrophilic dermatoses: a report of seven cases and review of the literature. Pediatr Dermatol. 2009;26:497–505.PubMedCrossRef

31.

Majeed HA, Al-Tarawna M, El-Shanti H, Kamel B, Al-Khalaileh F. The syndrome of chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anaemia. Report of a new family and a review. Eur J Pediatr. 2001;160:705–10.PubMed

32.

Omidi CJ, Siegfried EC. Chronic recurrent multifocal osteomyelitis preceding pyoderma gangrenosum and occult ulcerative colitis in a pediatric patient. Pediatr Dermatol. 1998;15:435–8.PubMedCrossRef

33.

Koturoglu G, Vardar F, Ozkinay F, Kurugol Z, Akalin T, Ozkinay C. Pyoderma gangrenosum in a six-month-old boy. Turk J Pediatr. 2006;48:159–61.PubMed

34.

Sonozaki H, Mitsui H, Miyanaga Y, Okitsu K, Igarashi M, Hayashi Y, Matsuura M, Azuma A, Okai K, Kawashima M. Clinical features of 53 cases with pustulotic arthro-osteitis. Ann Rheum Dis. 1981;40:547–53.PubMedCrossRef

35.

Vittecoq O, Said LA, Michot C, Mejjad O, Thomine JM, Mitrofanoff P, Lechevallier J, Ledosseur P, Gayet A, Lauret P, le Loet X. Evolution of chronic recurrent multifocal osteitis toward spondylarthropathy over the long term. Arthritis Rheum. 2000;43:109–19.PubMedCrossRef

36.

Rech J, Manger B, Lang B, Schett G, Wilhelm M, Birkmann J. Adult-onset Still’s disease and chronic recurrent multifocal osteomyelitis: a hitherto undescribed manifestation of autoinflammation. Rheumatol Int 2011 [E-published ahead of print]. doi:10.1007/s00296-011-2020-x.

37.

Job-Deslandre C, Krebs S, Kahan A. Chronic recurrent multifocal osteomyelitis: five-year outcomes in 14 pediatric cases. Joint Bone Spine. 2001;68:245–51.PubMedCrossRef

38.

Kim JE, Kolh EM, Kim DK. Takayasu’s arteritis presenting with focal periostitis affecting two limbs. Int J Cardiol. 1998;67:267–70.PubMedCrossRef

39.

McConachie NS, Morley KD, Jones MC. Case report: periosteal new bone formation in Takayasu arteritis. Clin Radiol. 1995;50:578–80.PubMedCrossRef

40.

Pelkonen P, Ryoppy S, Jaaskelainen J, Rapola J, Repo H, Kaitila I. Chronic osteomyelitislike disease with negative bacterial cultures. Am J Dis Child. 1988;142:1167–73.PubMed

41.

Kerem E, Manson D, Laxer RM, Levison H, Reilly BJ. Pulmonary association in a case of chronic recurrent multifocal osteomyelitis. Pediatr Pulmonol. 1989;7:55–8.PubMedCrossRef

42.

Ravelli A, Marseglia GL, Viola S, Ruperto N, Martini A. Chronic recurrent multifocal osteomyelitis with unusual features. Acta Paediatr. 1995;84:222–5.PubMedCrossRef

43.

Majeed SA. Chronic recurrent multifocal osteomyelitis associated with tumoral calcinosis. J Bone Joint Surg Br. 1994;76:325–7.PubMed

44.

Maus U, Ihme N, Schroeder S, Andereya S, Ohnsorge JA, Hermanns B, Deutz P, Niedhart C. Chronic recurrent multifocal osteomyelitis and tumoral calcinosis—is there an association? Klinische Padiatrie. 2007;219:277–81.PubMedCrossRef

45.

Yurdoglu C, Ozbaydar MU, Adas M, Ozger H. Familial tumoral calcinosis in three patients in the same family. Acta Orthopaedica et Traumatologica Turcica. 2007;41:244–8.PubMed

46.

Ferguson PJ, El-Shanti HI. Autoinflammatory bone disorders. Curr Opin Rheumatol. 2007;19:492–8.PubMedCrossRef

47.

Backues KA, Hoover JP, Bahr RJ, Confer AW, Chalman JA, Larry ML. Multifocal pyogranulomatous osteomyelitis resembling chronic recurrent multifocal osteomyelitis in a lemur. J Am Vet Med Assoc. 2001;218:250–3.PubMedCrossRef

48.

Ferguson PJ, Bing X, Vasef MA, Ochoa LA, Mahgoub A, Waldschmidt TJ, Tygrett LT, Schlueter AJ, El-Shanti H. A missense mutation in pstpip2 is associated with the murine autoinflammatory disorder chronic multifocal osteomyelitis. Bone. 2006;38:41–7.PubMedCrossRef

49.

Grosse J, Chitu V, Marquardt A, Hanke P, Schmittwolf C, Zeitlmann L, Schropp P, Barth B, Yu P, Paffenholz R, Stumm G, Nehls M, Stanley ER. Mutation of mouse Mayp/Pstpip2 causes a macrophage autoinflammatory disease. Blood. 2006;107:3350–8.PubMedCrossRef

50.

Safra N, Pedersen NC, Wolf Z, Johnson EG, Liu HW, Hughes AM, Young A, Bannasch DL. Expanded dog leukocyte antigen (DLA) single nucleotide polymorphism (SNP) genotyping reveals spurious class II associations. Veterinary J. 2011;189:220–6.CrossRef

51.

Woodard JC. Canine hypertrophic osteodystrophy, a study of the spontaneous disease in littermates. Veterinary Pathol. 1982;19:337–54.CrossRef

52.

Harrus S, Waner T, Aizenberg, Safra N, Mosenco A, Radoshitsky M, Bark H. Development of hypertrophic osteodystrophy and antibody response in a litter of vaccinated Weimaraner puppies. J Small Anim Pract. 2002;43:27–31.PubMedCrossRef

53.

Abeles V, Harrus S, Angles JM, Shalev G, Aizenberg I, Peres Y, Aroch I. Hypertrophic osteodystrophy in six weimaraner puppies associated with systemic signs. Vet Rec. 1999;145:130–4.PubMedCrossRef

54.

Golla A, Jansson A, Ramser J, Hellebrand H, Zahn R, Meitinger T, Belohradsky BH, Meindl A. Chronic recurrent multifocal osteomyelitis (CRMO): evidence for a susceptibility gene located on chromosome 18q21.3-18q22. Eur J Hum Genet. 2002;10:217–21.PubMedCrossRef

55.

Ben Becher S, Essaddam H, Nahali N, Ben Hamadi F, Mouelhi MH, Hammou A, Hadj Romdhane L, Ben Cheikh M, Boudhina T, Dargouth M. Recurrent multifocal periostosis in children. Report of a familial form. Ann Pediatr (Paris). 1991;38:345–9.

56.

Festen JJ, Kuipers FC, Schaars AH. Multifocal recurrent periostitis responsive to colchicine. Scand J Rheumatol. 1985;14:8–14.PubMedCrossRef

57.

Hamel J, Paul D, Gahr M, Hedrich CM. Pilot study: possible association of IL10 promoter polymorphisms with CRMO. Rheumatol Int 2011[e-pub ahead of time] doi:10.1007/s00296-010-1768-8.

58.

Morbach H, Dick A, Beck C, Stenzel M, Muller-Hermelink HK, Raab P, Girschick HJ. Association of chronic non-bacterial osteomyelitis with Crohn’s disease but not with CARD15 gene variants. Rheumatol Int. 2010;30:617–21.PubMedCrossRef

59.

Beck C, Girschick HJ, Morbach H, Schwarz T, Yimam T, Frenkel J, van Gijn ME. Mutation screening of the IL-1 receptor antagonist gene in chronic non-bacterial osteomyelitis of childhood and adolescence. Clin. Exp. Rheumatol [e-pub ahead of print], Oct 27, 2011. http://www.ncbi.nlm.nih.gov/pubmed/22032624.

60.

Majeed HA, El-Shanti H, Al-Rimawi H, Al-Masri N. On mice and men: an autosomal recessive syndrome of chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anemia. J Pediatr. 2000;137:441–2.PubMedCrossRef

61.

Al-Mosawi ZS, Al-Saad KK, Ijadi-Maghsoodi R, El-Shanti HI, Ferguson PJ. A splice site mutation confirms the role of LPIN2 in Majeed syndrome. Arthritis Rheum. 2007;56:960–4.PubMedCrossRef

62.

Ferguson PJ, Chen S, Tayeh MK, Ochoa L, Leal SM, Pelet A, Munnich A, Lyonnet S, Majeed HA, El-Shanti H. Homozygous mutations in LPIN2 are responsible for the syndrome of chronic recurrent multifocal osteomyelitis and congenital dyserythropoietic anaemia (Majeed syndrome). J Med Genet. 2005;42:551–7.PubMedCrossRef

63.

Donkor J, Sariahmetoglu M, Dewald J, Brindley DN, Reue K. Three mammalian lipins act as phosphatidate phosphatases with distinct tissue expression patterns. J Biol Chem. 2007;282:3450–7.PubMedCrossRef

64.

Donkor J, Zhang P, Wong S, O’Loughlin L, Dewald J, Kok BP, Brindley DN, Reue K. A conserved serine residue is required for the phosphatidate phosphatase activity but not transcriptional coactivator functions of lipin-1 and lipin-2. J Biol Chem. 2009;284:29968–78.PubMedCrossRef

65.

Peterfy M, Phan J, Xu P, Reue K. Lipodystrophy in the fld mouse results from mutation of a new gene encoding a nuclear protein, lipin. Nat Genet. 2001;27:121–4.PubMedCrossRef

66.

Langner CA, Birkenmeier EH, Ben-Zeev O, Schotz MC, Sweet HO, Davisson MT, Gordon JI. The fatty liver dystrophy (fld) mutation. A new mutant mouse with a developmental abnormality in triglyceride metabolism and associated tissue-specific defects in lipoprotein lipase and hepatic lipase activities. J Biol Chem. 1989;264:7994–8003.PubMed

67.

Reue K, Xu P, Wang XP, Slavin BG. Adipose tissue deficiency, glucose intolerance, and increased atherosclerosis result from mutation in the mouse fatty liver dystrophy (fld) gene. J Lipid Res. 2000;41:1067–76.PubMed

68.

Reue K, Dwyer JR. Lipin proteins and metabolic homeostasis. J Lipid Res. 2009;50(Suppl):S109–114.PubMedCrossRef

69.

•• Reue K. The lipin family: mutations and metabolism. Curr Opin Lipidol. 2009;20:165–70. This is an excellent review of the function of the Lipin proteins.PubMedCrossRef

70.

Zeharia A, Shaag A, Houtkooper RH, Hindi T, de Lonlay P, Erez G, Hubert L, Saada A, de Keyzer Y, Eshel G, Vaz FM, Pines O, Elpeleg O. Mutations in LPIN1 cause recurrent acute myoglobinuria in childhood. Amer J Hum Genet. 2008;83:489–94.PubMedCrossRef

71.

•• Donkor J, Zhang P, Wong S, O’Loughlin L, Dewald J, Kok BP, Brindley DN, Reue K. A conserved serine residue is required for the phosphatidate phosphatase activity but not the transcriptional coactivator functions of lipin-1 and lipin-2. J Biol Chem. 2009;284:29968–78. This study demonstrated that a Majeed syndrome mutation disrupts PAP activity in Lipin2.PubMedCrossRef

72.

Herlin T, Bjerre M, Fiirgaard B, Kerndrup G, Hasle H, Ferguson PJ. Novel mutation of the LPIN2 gene in Majeed syndrome. Response to IL-1 inhibition. Arthritis Rheum 2011;63(10) supplement: S112.

73.

Prose NS, Fahrner LJ, Miller CR, Layfield L. Pustular psoriasis with chronic recurrent multifocal osteomyelitis and spontaneous fractures. J Am Acad Dermatol. 1994;31:376–9.PubMedCrossRef

74.

• Stenerson M, Dufendach K, Aksentijevich I, Brady J, Austin J, Reed AM. The first reported case of compound heterozygous IL1RN mutations causing deficiency of the interleukin-1 receptor antagonist. Arthritis Rheum. 2011;63:4018–22. This was a report of a child with DIRA and a new mutation in IL1RN carried in a compound heterozygous state.PubMedCrossRef

75.

• Jesus AA, Osman M, Silva CA, Kim PW, Pham TH, Gadina M, Yang B, Bertola DR, Carneiro-Sampaio M, Ferguson PJ, Renshaw BR, Schooley K, Brown M, Al-Dosari A, Al-Alami J, Sims JE, Goldbach-Mansky R, El-Shanti H. A novel mutation of IL1RN in the deficiency of interleukin-1 receptor antagonist syndrome: description of two unrelated cases from Brazil. Arthritis Rheum. 2011;63:4007–17. This study reported the clinical manifestations and genetic defects in two infants with DIRA.PubMedCrossRef

76.

•• Marrakchi S, Guigue P, Renshaw BR, Puel A, Pei XY, Fraitag S, Zribi J, Bal E, Cluzeau C, Chrabieh M, Towne JE, Douangpanya J, Pons C, Mansour S, Serre V, Makni H, Mahfoudh N, Fakhfakh F, Bodemer C, Feingold J, Hadj-Rabia S, Favre M, Genin E, Sahbatou M, Munnich A, Casanova JL, Sims JE, Turki H, Bachelez H, Smahi A. Interleukin-36-receptor antagonist deficiency and generalized pustular psoriasis. N Engl J Med. 2011;365:620–8. This study identified a gene defect in the IL36 receptor antagonist gene causing generalized pustulosis without bone inflammation.PubMedCrossRef

77.

Goldbach-Mansky R. Current status of understanding the pathogenesis and management of patients with NOMID/CINCA. Curr Rheumatol Reports. 2011;13:123–31.CrossRef

78.

• Twilt M, Laxer RM. Clinical care of children with sterile bone inflammation. Curr Opin Rheumatol. 2011;23:424–31. This is an excellent review of treatment of CRMO.PubMedCrossRef

79.

•• Beck C, Morbach H, Beer M, Stenzel M, Tappe D, Gattenlohner S, Hofmann U, Raab P, Girschick HJ. Chronic nonbacterial osteomyelitis in childhood: prospective follow-up during the first year of anti-inflammatory treatment. Arthritis Res Ther. 2010;12:R74. This was the first prospective study of response to NSAIDs in CRMO.PubMedCrossRef

80.

• Miettunen PM, Wei X, Kaura D, Reslan WA, Aguirre AN, Kellner JD. Dramatic pain relief and resolution of bone inflammation following pamidronate in 9 pediatric patients with persistent chronic recurrent multifocal osteomyelitis (CRMO). Pediatr Rheumatol Online J. 2009;7:2. This is a prospective analysis of response to bisophosphonates in nine children with CRMO.PubMedCrossRef

81.

• Eleftheriou D, Gerschman T, Sebire N, Woo P, Pilkington CA, Brogan PA. Biologic therapy in refractory chronic non-bacterial osteomyelitis of childhood. Rheumatol. 2010;49:1505–12. This is a summary of response to treatment in children with CRMO treated with biologic agents.CrossRef

82.

Marangoni RG, Halpern AS. Chronic recurrent multifocal osteomyelitis primarily affecting the spine treated with anti-TNF therapy. Spine. 2010;35:E253–256.PubMed

83.

Simm PJ, Allen RC, Zacharin MR. Bisphosphonate treatment in chronic recurrent multifocal osteomyelitis. J Pediatr. 2008;152:571–5.PubMedCrossRef

84.

Hospach T, Langendoerfer M, von Kalle T, Maier J, Dannecker GE. Spinal involvement in chronic recurrent multifocal osteomyelitis (CRMO) in childhood and effect of pamidronate. European J Pediatr. 2010;169:1105–11.CrossRef

85.

Compeyrot-Lacassagne S, Rosenberg AM, Babyn P, Laxer RM. Pamidronate treatment of chronic noninfectious inflammatory lesions of the mandible in children. J Rheumatol. 2007;34:1585–9.PubMed

86.

De Cunto A, Maschio M, Lepore L, Zennaro F. A case of chronic recurrent multifocal osteomyelitis successfully treated with neridronate. J Pediatr. 2009;154:154–5.PubMed

87.

Yamazaki Y, Satoh C, Ishikawa M, Notani K, Nomura K, Kitagawa Y. Remarkable response of juvenile diffuse sclerosing osteomyelitis of mandible to pamidronate. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:67–71.PubMedCrossRef

88.

Kerrison C, Davidson JE, Cleary AG, Beresford MW. Pamidronate in the treatment of childhood SAPHO syndrome. Rheumatol (Oxford). 2004;43:1246–51.CrossRef

89.

Kuijpers SC, de Jong E, Hamdy NA, van Merkesteyn JP. Initial results of the treatment of diffuse sclerosing osteomyelitis of the mandible with bisphosphonates. J Craniomaxillofac Surg. 2011;39:65–8.PubMedCrossRef

90.

Gleeson H, Wiltshire E, Briody J, Hall J, Chaitow J, Sillence D, Cowell C, Munns C. Childhood chronic recurrent multifocal osteomyelitis: pamidronate therapy decreases pain and improves vertebral shape. J Rheumatol. 2008;35:707–12.PubMed

91.

Aktay Ayaz N, Topaloglu R, Ozaltin F, Caglar Tuncali M, Bakkaloglu A. A case of chronic recurrent multifocal osteomyelitis successfully treated with etanercept. Pediatr Rheumatol 2008; 6(S1): 191. doi:10.1186/1546-0096-6-S1-P191.

92.

Eisenstein EM, Syverson GD, Vora SS, Williams CB. Combination therapy with methotrexate and etanercept for refractory chronic recurrent multifocal osteomyelitis. J Rheumatol. 2011;38:782–3.PubMedCrossRef

93.

Deutschmann A, Mache CJ, Bodo K, Zebedin D, Ring E. Successful treatment of chronic recurrent multifocal osteomyelitis with tumor necrosis factor-alpha blockage. Pediatr. 2005;116:1231–3.CrossRef

94.

Wolber C, David-Jelinek K, Udvardi A, Artacker G, Volc-Platzer B, Kurz H. Successful therapy of sacroiliitis in SAPHO syndrome by etanercept. Wiener medizinische Wochenschrift. 2011;161:204–8.PubMedCrossRef

95.

Coloe J, Diamantis S, Henderson F, Morrell DS. Synovitis-acne-pustulosis-hyperostosis-osteitis (SAPHO) syndrome complicated by seven pulmonary emboli in a 15-year old patient. J Amer Acad Dermatol. 2010;62:333–6.CrossRef

96.

Stern S, Marzan K, Borzutzky A, Steinberg E, Reiff A. Use of TNF antagonists in the treatment of chronic non-bacterial osteomyelitis (CNO). Arthritis Rheum 2010;62(10)supplement: S101.

97.

Colina M, Pizzirani C, Khodeir M, Falzoni S, Bruschi M, Trotta F, Di Virgilio F. Dysregulation of P2X7 receptor-inflammasome axis in SAPHO syndrome: successful treatment with anakinra. Rheumatol. 2010;49:1416–8.CrossRef

Title: Current Understanding of the Pathogenesis and Management of Chronic Recurrent Multifocal Osteomyelitis
Authors: Polly J. Ferguson
Monica Sandu
Publication date: 01-04-2012
Publisher: Current Science Inc.
Published in: Current Rheumatology Reports / Issue 2/2012
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI: https://doi.org/10.1007/s11926-012-0239-5

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Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.

Watch now

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

Illustration of figure on mountain summit/© Orapun / Stock.adobe.com, STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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Other articles of this Issue 2/2012

Pediatric Vasculitis

Update on the Phenotypic Spectrum of Lesch-Nyhan Disease and its Attenuated Variants

Gout and Organ Transplantation

Axial (Spinal) Gout

What Do Cytokine Profiles Tell Us About Subsets of Juvenile Idiopathic Arthritis?

Regulation of Uric Acid Excretion by the Kidney

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage