Successful treatment of chronic recurrent multifocal osteomyelitis with tumor necrosis factor-alpha blockage.
We describe the case of an 18-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) over a period of 10 years. She had suffered predominantly from very painful recurrent swelling of her cheeks. Various therapeutic regimens including nonsteroidal antiinflammatory drugs and steroids had shown only a partial or temporary response. Because tumor necrosis factor-alpha-blocking agents have been successfully applied in Crohn's-associated CRMO and the related SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome, tumor necrosis factor-alpha-blocking therapy with infliximab was initiated. Thereafter, apart from 1 mild episode, no additional recurrences were observed during 21 months of follow-up. Infliximab was well tolerated, and steroids were tapered off. Our observation indicates that infliximab may be an effective therapeutic option in CRMO.
Deutschmann
Andrea
A
Department of Pediatrics, Medical University of Graz, Graz, Austria. andrea.deutschmann@meduni-graz.at
Mache
Christoph J
CJ
Bodo
Koppany
K
Zebedin
Doris
D
Ring
Ekkehard
E
D000293:Adolescent; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001706:Biopsy; D002908:Chronic Disease; D005260:Female; D006801:Humans; D000069285:Infliximab; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D012008:Recurrence; D012886:Skull / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab