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Deprecated: Implicit conversion from float 213.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Pediatr+Rheumatol+Online+J 2015 ; 13 (ä): ä Nephropedia Template TP
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Chronic nonbacterial osteomyelitis in children: a retrospective multicenter study #MMPMID26088861
Kaiser D; Bolt I; Hofer M; Relly C; Berthet G; Bolz D; Saurenmann T
Pediatr Rheumatol Online J 2015[]; 13 (ä): ä PMID26088861show ga
Background: To determine the clinical presentation, current treatment and outcome of children with nonbacterial inflammatory bone disease. Methods: Retrospective multicenter study of patients entered into the Swiss Pediatric Rheumatology Working Group registry with a diagnosis of chronic nonbacterial osteomyelitis (CNO) and synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome. The charts were reviewed for informations about disease presentation, treatment, course and outcome. Results: Forty-one children (31 girls and 10 boys) from 6 pediatric hospitals in Switzerland diagnosed between 1995 and 2010 were included in the study. The diagnosis was multifocal CNO (n?=?33), unifocal CNO (n?=?4) and SAPHO syndrome (n?=?4). Mean age at onset of CNO was 9.5 years (range 1.4?15.6) and mean follow-up time was 52 months (range 6?156 months). Most patients (n?=?27) had a chronic persistent disease course (>6 months), 8 patients had a course with one or more relapses and 6 patients had only one episode of CNO. Forty nine percent had received at least one course of antibiotics. In 57 % treatment with nonsteroidal anti-inflammatory drugs (NSAID) was sufficient to control the disease. Twelve out of 16 children with NSAID failure subsequently received corticosteroids, methotrexate, TNF ? inhibitors, bisphosphonates or a combination of these drugs. Conclusions: In a multicenter cohort of 41 children 22 % started with unifocal lesion with a significant diagnostic delay. A higher proportion presented with chronic persistent disease than with a recurrent form. An osteomyelitis in the pelvic region is significantly associated with other features of juvenile spondylarthritis.