Clinical experiences in Turkish paediatric patients with chronic recurrent multifocal osteomyelitis

Abstract

Chronic recurrent multifocal osteomyelitis (CRMO) is a clinical entity whichoccurs mainly in children and adolescents with recurrent episodes of painoccurring over several years. Cause and physiopathology of disease is stilluncertain. We aim to assess clinical characteristics and treatment options,need and response to anti-inflammatory therapies in children diagnosedchronic recurrent multifocal osteomyelitisDemographic data and clinical features of seventeen children diagnosedwith CRMO in 2 pediatric rheumatology centers in Turkey were reviewedretrospectively. The diagnosis was based on clinical findings, radiologicalimages and histopathological and microbiological studies.A total of 17 patients were included in the study. The median age of diagnosiswas 9.6±4.2 years. The mean follow-up time was 31.6 months (range 6–35months). Most patients (n: 10) had a recurrent multifocal disease course(>6 months), 6 patients had a persistent course and a patient had only oneepisode of CRMO. MEFV gene mutations were detected in 4 patients whoseclinical features reduced with colchicine therapy. All patients had receivednonsteroidal anti-inflammatory drugs but only one had complete response.Thirteen children with NSAID failure subsequently received corticosteroids,sulfasalazine, methotrexate, Anti TNF α drugs, or a combination of thesedrugs.This study is the largest cohort of pediatric CRMO patients in our country.Clinical evolution and imaging investigations should be closely done to avoiddelays in diagnosis. Ethnic differences create changes in the presentation ofthe disease and response to treatment