Remarkable response of juvenile diffuse sclerosing osteomyelitis of mandible to pamidronate.
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.
Yamazaki
Yutaka
Y
Department of Oral Diagnosis and Medicine, Graduate School of Dental Medicine, Hokkaido University, Kita-ku, Sapporo, Japan. yutaka8@den.hokudai.ac.jp
Satoh
Chiharu
C
Ishikawa
Makoto
M
Notani
Ken-ichi
K
Nomura
Katsuhiro
K
Kitagawa
Yoshimasa
Y
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
D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D000077268:Pamidronate