Aktay Ayaz, N

Bakkaloglu, A

Topaloglu, R

Çaglar Tuncali, M

Özaltin, F

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Aktay Ayaz N

Topaloglu R

Özaltin F

Çaglar Tuncali M

Bakkaloglu A

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Pediatric Rheumatology

A case of chronic recurrent multifocal osteomyelýtýs successfully treated with etanercept

Hacettepe University Institutional Repository

A Case Of Chronic Recurrent Multifocal Osteomyelýtýs Successfully Treated With Etanercept

N Aktay Ayaz

R Topaloglu

F Özaltin

M Çaglar Tuncali

A Bakkaloglu

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BioMed Central
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Pediatric Rheumatology
Open AccessPoster presentation
A case of chronic recurrent multifocal osteomyelýtýs successfully 
treated with etanercept
N Aktay Ayaz*, R Topaloglu, F Özaltin, M Çaglar Tuncali and A Bakkaloglu
Address: Hacettepe Univesity Medical Faculty, Ankara, Turkey
* Corresponding author    
Chronic recurrent multifocal osteomyelitis (CRMO) is a
disease of unknown origin characterised by multifocal
recurrent bone lesions without any microbial agent
detected from the lesion.
A 9-year-old girl presented with the complaint of leg and
arm pain. From her previous history it was learned that
she had had back pain 2 years ago and at another medical
center she had been evaluated with vertebral magnetic res-
onance imaging, vertebral tuberculosis had been sus-
pected there and she had been given antituberculous
treatment and non-specific antibiotic treatment. During
follow up, she had had new lesions in the sternum and
radius.
She was re-evaluted in our clinic and bone scintigraphy
was performed with the possible diagnosis of CRMO. On
scintigraphy she had increased uptake of radioactive
material at the level of T12 vertebra and corpus sterni. Her
previous biopsy specimens were found to be non-specific
chronic osteomyelitis. She had a very high sedimentation
rate and elevated CRP levels. During follow up with non-
steroid anti-inflammatory agents she developed a severe
achilles tendonitis. She had a positive HLA B27 test. Due
to the progression of her disease both clinically and labo-
ratory values she was started etanercept treatment. After a
follow up period of 6 months she was clinically silent and
her control bone scintigraphy was obviously better than
her first scintigraphy.
From the previous studies it is known that there is intense
expression and production of TNF-α in bone lesions. We
conclude that especially in refractory CRMO cases etaner-
cept may be an effective treatment option.
from 15th Paediatric Rheumatology European Society (PreS) Congress
London, UK. 14–17 September 2008
Published: 15 September 2008
Pediatric Rheumatology 2008, 6(Suppl 1):P191 doi:10.1186/1546-0096-6-S1-P191
<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/P191
© 2008 Aktay Ayaz et al; licensee BioMed Central Ltd. 


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A case of chronic recurrent multifocal osteomyelýtýs successfully treated with etanercept

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