title: Remarkable response of juvenile diffuse sclerosing osteomyelitis of mandible to pamidronate.
abstract: We report a juvenile case of diffuse sclerosing osteomyelitis of the mandible that showed a favorable response to pamidronate, a bisphosphonate derivative. Although conventional treatments had been ineffective for 5 years, pamidronate administration brought about conspicuous improvement both clinically and radiographically. Severe adverse reaction was not found except for low-grade fever and lassitude on the day following administration. During the course of the treatment, however, nonsuppurative osteomyelitis of the right humerus also occurred, leading to the established diagnosis of chronic recurrent multifocal osteomyelitis. Pamidronate therapy was again performed successfully with near disappearance of clinical symptoms. Both bone-specific alkaline phosphatase (bone formation marker) and pyridinoline cross-linked carboxyterminal telopeptide of type I collagen (bone resorption marker) showed a marked decrease with pamidronate therapy, suggesting that pamidronate is useful for the treatment of chronic recurrent multifocal osteomyelitis with inhibitory effect on bone turnover.
authors.affiliation: Department of Oral Diagnosis and Medicine, Graduate School of Dental Medicine, Hokkaido University, Kita-ku, Sapporo, Japan. yutaka8@den.hokudai.ac.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: Chiharu
authors.initials: C
authors.lastname: Satoh
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishikawa
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Notani
authors.forename: Katsuhiro
authors.initials: K
authors.lastname: Nomura
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D050071:Bone Density Conservation Agents / Q000627:therapeutic use*; D002648:Child; D002908:Chronic Disease; D004164:Diphosphonates / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000175:diagnosis / Q000188:drug therapy*; D010019:Osteomyelitis / Q000175:diagnosis / Q000188:drug therapy*; D000077268:Pamidronate; D012008:Recurrence; D014081:Tooth Extraction / Q000009:adverse effects
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate