Publication: Clinical features of children with chronic non-bacterial osteomyelitis: A multicenter retrospective case series from Turkey
Date
2021-09-01
Authors
Authors
Acari, Ceyhun
Comak, Elif
Turkucar, Serkan
Dundar, Hatice Adiguzel
Akman, Sema
Makay, Balahan
Unsal, Sevket Erbil
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Volume Title
Publisher
Turkish League Against Rheumatism
Abstract
Objectives: This study aims to evaluate demographic, clinical, and radiological characteristics of Turkish children with chronic non-bacterial osteomyelitis.Patients and methods: Between January 2008 and December 2018, a total of 28 patients (10 males, 18 females; median age: 12.5 years; range, 4.5 to 21 years) who were diagnosed with chronic non-bacterial osteomyelitis in three pediatric rheumatology centers were retrospectively analyzed. The demographic, clinical, and laboratory findings of the patients were recorded.Results: The median age at the time of diagnosis was 10.2 years. The median time from symptom onset to diagnosis was 6.5 months. The median follow-up was 18.5 months. The most frequent symptom at onset was arthralgia (75.0%). The most frequently involved bone was the femur (67.9%). Eight (63.6%) of 12 patients had at least one Mediterranean fever gene (MEFV) mutation, indicating a significantly higher prevalence than the Turkish population (14.8%). Five of these patients fulfilled the diagnostic criteria for familial Mediterranean fever (FMF). All patients received non-steroidal anti-inflammatory drugs. Other drugs were methotrexate (46.4%), sulfasalazine (39%), corticosteroids (25%), anti-tumor necrosis factor (anti-TNF) agents (32%), pamidronate (25%), and colchicine (21.4%). Six of eight patients with MEFV mutations were administered with colchicine, and all of them responded to treatment.Conclusion: Clinical evolution and imaging investigations should be carefully performed to prevent any delay in the diagnosis of patients with chronic non-bacterial osteomyelitis. Based on our study results, FMF coexistence is worth investigating in patients with chronic non-bacterial osteomyelitis, particularly in the Turkish population.
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Keywords
Recurrent multifocal osteomyelitis, Classification, Osteitis, Children, Familial mediterranean fever, Mefv mutation, Non-bacterial osteomyelitis, Science & technology, Life sciences & biomedicine, Rheumatology, Rheumatology
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