Fantini, F

Gattinara, M

Gerloni, V

Pontikaki, I

Salmaso, A

Teruzzi, B

Pediatric Rheumatology

English

PubMed

B Teruzzi

A Salmaso

V Gerloni

M Gattinara

I Pontikaki

F Fantini

Crossref

Chronic Recurrent Multifocal Osteomyelitis (CRMO): four cases treated with aminobisphosphonate (pamidronate)

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BioMed Central
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Pediatric Rheumatology
Open AccessPoster presentation
Chronic Recurrent Multifocal Osteomyelitis (CRMO): four cases 
treated with aminobisphosphonate (pamidronate)
B Teruzzi*, A Salmaso, V Gerloni, M Gattinara, I Pontikaki and F Fantini
Address: G.Pini Institute-UOS of Paediatric Rheumatology, Milan, Italy
* Corresponding author    
CRMO is an autoinflammatory disease of children and
young adults, characterized by the insidious onset of local
pain and swelling in affected bone and fever. The bone
lesions are radiologically characterized as multiple luciens
surrounded by defined zones of patchy but dense sclero-
sis, cortical tickening from periosteal new bone forma-
tion, and increased bone size with different bones
involved. Diagnosis is based upon laboratory tests (ele-
vated levels of CRP/ESR), bone scintigraphy and MRI
findings and is proved by open bone biopsy. Recently
bisphosphonate therapy, and particulary i.v. pamidro-
nate, has been proposed as treatment for patients both
CRMO who do not responder to NSAIDs therapy. We
report 4 cases of children affected by CRMO treated with
a therapeutic cycle of aminobisphosphonate (pamidro-
nate). In all pts. the diagnosis of CRMO was confirmed by
bone scintigraphy, MRI and open bone biopsy. Pt.1. 12-
years-old age (disease onset 10 yrs) presented with pain
and swelling of right ankle, hip, knee and breastbone;
CRP 2.4 mg/dl, ESR 100 mm/h. CRMO of right distal tib-
ial epiphysis, right peroneal malleulus, breastbone and
right hip. Pt.2. 5-years-old age presented with post-trau-
matic back pain in the past month and pathologic fracture
of three thoracic vertebrae; normal values of CRP and ESR.
CRMO of right iliac wing and thoracic spine (T8-T9-T10).
Pt.3. 8-years-old age presented lumbar pain and swelling
in the past month associated with antalgic scoliosis; CRP
< 0.5 mg/dl, ESR 40 mm/h. CRMO of left distal tibial epi-
physis, thoracic spine (T7–T8), right iliac wing. Pt.4 17-
years-old age (disease onset 11 yrs) presented with post-
traumatic pain and swelling of right hip and heel; CRP 1.6
mg/dl, ESR 29 mm/h. CRMO of bilateral distal tibial epi-
physis, left calcaneus and neck of right femur. All 4 pts.
were treated with 3 infusions of pamidronate 0.5–1.3 mg/
kg/day in 250 ml of saline solution i.v. infusion at day
1,3,5 and then monthly. Severe adverse reaction was not
found except for low-grade fever and lassitude on the day
following administration. In all pts a remarkable
improvement of painful symptoms was quikly achieved.
MRI performed 1–3 months after treatment showed an
important reduction of osteolytic, sclerotic and reactive
bone lesions, and normalization of inflammatory values
was observed. Our experience suggests that pamidronate
maybe an efficacious alternative to conventional treat-
ment in CRMO.
from 15th Paediatric Rheumatology European Society (PreS) Congress
London, UK. 14–17 September 2008
Published: 15 September 2008
Pediatric Rheumatology 2008, 6(Suppl 1):P189 doi:10.1186/1546-0096-6-S1-P189
<supplement> <title> <p>15<sup>th </sup>Paediatric Rheumatology European Society (PreS) Congress</p> </title> <editor>Wietse Kuis, Patricia Woo, Angelo Ravelli, Hermann Girschick, Michaël Hofer, Johannes Roth, Rotraud K Saurenmann, Alberto Martini, Pavla Dolezova, Janjaap van der Net, Pierre Quartier, Lucy Wedderburn and Jan Scott</editor> <note>Meeting abstracts – A single PDF containing all abstracts in this Supplement is available <a href="http://www.biomedcentral.com/content/files/PDF/1546-0096-6-S1-full.pdf">here</a>.</note> </supplement>
This abstract is available from: http://www.ped-rheum.com/content/6/S1/P189
© 2008 Teruzzi et al; licensee BioMed Central Ltd. 


B. Teruzzi

A. Salmaso

F. Fantini

M. Gattinara

V. Gerloni

I. Pontikaki

AIR Universita degli studi di Milano

Chronic Recurrent Multifocal Osteomyelitis (CRMO) : four cases treated with Aminobisphosphonate (Pamidronate)

http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3333991

Chronic Recurrent Multifocal Osteomyelitis (CRMO): four cases treated with aminobisphosphonate (pamidronate)

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