[Non-bacterial chronic osteomyelitis: Experience in a tertiary hospital].
BACKGROUND
Non-bacterial chronic osteomyelitis (NBCO) is an autoinflammatory disease that presents with recurrent bouts of bone inflammation in the absence of microbiological isolation. It is a diagnosis of exclusion. Its treatment was classically based on the use of non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, although nowadays bisphosphonates or anti-tumour necrosis factor-α (anti-TNF) drugs are frequently used with good results. The objective of the study is to describe our experience in the diagnosis and treatment of patients with NBCO.


METHODS
Retrospective chart review of patients with NBCO followed up in a tertiary centre between 2008 and 2015.


RESULTS
A total of 7 patients with NBCO were recorded. Four were female and the median age was 10 years (IQR 2). The most common complaint was pain that interfered with sleep in 5 of the patients. Six patients had multifocal lesions at diagnosis. Bone biopsy demonstrated neutrophilic or lymphocytic infiltration and sclerosis in 6 patients. Four patients received antibiotics and NSAIDs without clinical response. Five received a short course of prednisone with an adequate control of symptoms, but only one of them maintained remission after corticosteroid suspension. Five patients received bisphosphonates with disease remission in 3 of them. The other 2 showed an inadequate response to pamidronate and were started on anti-TNF therapy (etanercept, infliximab or adalimumab), remaining asymptomatic at present.


CONCLUSIONS
Our series, although limited, confirms the effectiveness and safety of bisphosphonate and anti-TNF therapy for children with NBCO.
Centro de Salud García Noblejas, Madrid, España; Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España. Electronic address: estefania.barral@salud.madrid.org.
Estefanía
E
Barral Mena
Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España.
Xabier
X
Freire Gómez
Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España.
Eugenia
E
Enríquez Merayo
Centro de Salud de Santa Ponsa, Calvià (Baleares), España.
Rocío
R
Casado Picón
Servicio de Pediatría, Hospital Universitario Rey Juan Carlos, Móstoles, Madrid, España.
Pablo
P
Bello Gutierrez
Unidad de Reumatología Pediátrica, Hospital Universitario 12 de Octubre, Madrid, España.
Jaime
J
de Inocencio Arocena
D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis* / Q000188:drug therapy*; D012189:Retrospective Studies; D062606:Tertiary Care Centers
Bifosfonatos; Biological therapy; Bisphosphonates; Chronic recurrent multifocal osteomyelitis; Osteitis; Osteomielitis crónica multifocal recurrente; Osteítis; Terapia biológica